HB2926 - 571R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 36-2901.07, Arizona Revised Statutes, is amended to read:

START_STATUTE36-2901.07. Definition of eligible person; conditional eligibility

A. Beginning January 1, 2014, for the purposes of section 36-2901, "eligible person" includes a person who is eligible pursuant to 42 United States Code section 1396a(a)(10)(A)(i)(VIII) and whose household's modified adjusted gross income is more than one hundred per cent percent but equal to or less than one hundred thirty-three per cent percent of the federal poverty guidelines.

B. The administration shall discontinue eligibility for a person who is eligible pursuant to subsection A of this section if the federal medical assistance percentage established pursuant to 42 United States Code section 1396d(y) or 1396d(z) that is applicable to this state is less than eighty per cent ninety percent.

C. The administration shall discontinue eligibility for persons who are eligible pursuant to subsection A of this section if the maximum amount that can be assessed under section 36-2901.08 without causing a reduction in federal financial participation, in combination with the monies specified in section 36-2901.09 and any other monies appropriated for the costs of this section and costs specified in section 36-2901.08, subsection A, is insufficient to cover those costs.

D. The administration shall discontinue eligibility for persons who are eligible pursuant to subsection a of this section if any of the following is not met:

1. The administration has implemented a work requirement for able-bodied adults who are enrolled in the system pursuant to section 36-2903.09 in which a person is not eligible to participate in the system unless the person:

(a) Is working at least twenty hours per week, averaged monthly.

(b) Is participating in and complying with the requirements of a work program that is at least twenty hours per week, as determined by the administration.

(d) Is meeting any combination of working and participating in a work program for at least twenty hours per week, as determined by the administration.

(e) Is participating in and complying with the requirements of a workfare program unless the person is any of the following:

(i) Under nineteen years of age.

(ii) At least sixty-four years of age.

(iii) Medically certified as physically or mentally unfit for employment.

(iv) Pregnant.

(v) A parent or caretaker who is responsible for the care of a dependent child who is under SIX YEARS OF age.

(vi) A parent or caretaker who is personally providing the care for a dependent child who has a serious medical condition or disability, as determined by the administration.

(vii) Receiving unemployment compensation and complying with work requirements that are part of the federal-state unemployment compensation system.

(viii) Participating in a drug addiction or alcohol treatment and rehabilitation program.

2. The administration has maintained a medicaid improper payment rate of five percent or less. tHE ADMINISTRATION SHALL PROVIDE TO the senate and house of representatives health and human services committees, or theIR successor committees, EVERY TWO YEARS FOR REVIEW data provided by the administration to the centers for medicare and medicaid services THAT DEMONSTRATES THE ADMINISTRATION'S MEDICAID IMPROPER PAYMENT RATE FOR THE PRECEDING TWO YEARS.

3. The administration has suspended, with federal approval if necessary, requirements to automatically renew eligibility based on available information and to use prepopulated renewal forms.

4. The administration has received an approved waiver pursuant to section 36-2903.09 and has implemented a lifetime benefit limit of sixty months for able-bodied adults, counting only time spent in that eligibility category.

5. The administration has implemented, with federal approval if necessary, biannual redeterminations for persons who are eligible under 42 United States Code section 1396a(a)(10)(A)(i)(VIII) and 42 United States Code section 1396a(e)(14).

6. The administration has limited, with federal approval if necessary, hospital presumptive eligibility determinations to children and pregnant women.

e. Not later than ninety days after October 1, 2025, the administration shall submit any necessary amendments or waivers to the current section 1115 waiver to the centers for medicare and medicaid services to implement this section. The administration shall take all actions necessary to implement this section as soon as practicable. The administration shall notify the health and human services committees, or their successor committees, in the senate and house of representatives within thirty days after the submission, approval, rejection or withdrawal of any federal amendment or waiver request or state plan amendment submitted to carry out this section. If any conditions required for eligibility under subsection A of this section are not met before ninety days after April 1, 2026, the administration shall terminate eligibility for persons described in subsection A of this section not later than January 1, 2027. If all conditions required for eligibility under subsection A of this section are met within ninety days after April 1, 2026 but are not met at any point thereafter, the administration shall terminate eligibility for persons described in subsection A of this section within ninety days after the date the conditions are not met. END_STATUTE

Sec. 2. Section 36-2901.08, Arizona Revised Statutes, is amended to read:

START_STATUTE36-2901.08. Hospital assessment

A. The director shall establish, administer and collect an assessment on hospital revenues, discharges or bed days for the purpose of funding the nonfederal share of the costs, except for costs of the services described in section 36-2907, subsection F, that are incurred beginning January 1, 2014 and that are not covered by the proposition 204 protection account established by section 36-778 and the Arizona tobacco litigation settlement fund established by section 36-2901.02 or any other monies appropriated to cover these costs, for all of the following individuals:

1. Persons who are defined as eligible pursuant to section 36-2901.07.

2. Persons who do not meet the eligibility standards described in the state plan or the section 1115 waiver that were in effect immediately before November 27, 2000, but who meet the eligibility standards described in the state plan as effective October 1, 2001.

3. Persons who are defined as eligible pursuant to section 36-2901.01 but who do not meet the eligibility standards in either section 36-2934 or the state plan in effect as of January 1, 2013.

B. The director shall adopt rules regarding the method for determining the assessment, the amount or rate of the assessment, and modifications or exemptions from the assessment. The assessment is subject to approval by the federal government to ensure that the assessment is not established or administered in a manner that causes a reduction in federal financial participation.

C. The director may establish modifications or exemptions to the assessment. In determining the modifications or exemptions, the director may consider factors including the size of the hospital, the specialty services available to patients and the geographic location of the hospital.

D. Before implementing the assessment, and thereafter if the methodology is modified, the director shall present the methodology to the joint legislative budget committee for review.

E. The administration shall not collect an assessment for costs associated with service after the effective date of any reduction of the federal medical assistance percentage established by 42 United States Code section 1396d(y) or 1396d(z) that is applicable to this state to less than eighty per cent NINETY PERCENT.

F. The administration shall deposit the revenues collected pursuant to this section in the hospital assessment fund established by section 36-2901.09.

G. A hospital shall not pass the cost of the assessment on to patients or third-party payors that are liable to pay for care on a patient's behalf. As part of its financial statement submissions pursuant to section 36-125.04, a hospital shall submit to the department of health services an attestation that it has not passed on the cost of the assessment to patients or third-party payors.

H. If a hospital does not comply with this section as prescribed by the director, the director may suspend or revoke the hospital's Arizona health care cost containment system provider agreement registration. If the hospital does not comply within one hundred eighty days after the director suspends or revokes the hospital's provider agreement, the director shall notify the director of the department of health services, who shall suspend or revoke the hospital's license pursuant to section 36-427. END_STATUTE

Sec. 3. Laws 2013, first special session, chapter 10, section 52 is amended to read:

Sec. 52. Conditional repeals

A. Sections 36-2901.07 and 36-2901.08, Arizona Revised Statutes, as added amended by this act, are repealed:

1. From and after the date the federal medical assistance percentage pursuant to 42 United States Code section 1396d(y) or 1396d(z) that is applicable to this state is less than eighty per cent ninety percent.

2. If the patient protection and affordable care act established pursuant to Public Law 111-148, as amended by the health care and education reconciliation act of 2010 pursuant to Public Law 111-152, is repealed.

3. If the maximum amount that can be assessed under section 36-2901.08, Arizona Revised Statutes, as added amended by this act, without causing a reduction in federal financial participation, in combination with the monies specified in section 36-2901.09, Arizona Revised Statutes, as added by this act, and any other monies appropriated for the costs for the populations specified in section 36-2901.08, subsection A, Arizona Revised Statutes, as added by this act, is insufficient to cover the costs described in section 36-2901.08, Arizona Revised Statutes, as added amended by this act.

B. The Arizona health care cost containment system administration shall notify the director of the Arizona legislative council in writing of the effective date if:

1. The federal medical assistance percentage under 42 United States Code section 1396d(y) or 1396d(z) that is applicable to this state is less than eighty per cent ninety percent.

2. The patient protection and affordable care act established pursuant to Public Law 111-148, as amended by the health care and education reconciliation act of 2010 pursuant to Public Law 111-152, is repealed.

3. The maximum amount that can be assessed under section 36-2901.08, Arizona Revised Statutes, as added amended by this act, without causing a reduction in federal financial participation, in combination with the monies specified in section 36-2901.09, Arizona Revised Statutes, as added by this act, and any other monies appropriated for the costs for the populations specified in section 36-2901.08, subsection A, Arizona Revised Statutes, as added by this act, is insufficient to cover the costs described in section 36-2901.08, Arizona Revised Statutes, as added amended by this act.