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ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
appropriation; behavioral health fee schedule
Purpose
Appropriates $15,000,000 from the state General Fund (state GF) to the Arizona Health Care Cost Containment System (AHCCCS) in FY 2026 for a 5 percent increase to the outpatient behavioral health fee schedule and outlines reporting requirements.
Background
Most AHCCCS
members receive all behavioral health services through the member's chosen
AHCCCS Complete Care Plan. Outpatient behavioral health services through AHCCCS
include: 1) screening provided by a behavioral health professional or a
behavioral health technician; 2) a behavioral health assessment provided by a behavioral health professional or a
behavioral health technician; 3) counseling, including individual therapy,
group therapy, and family therapy provided by a behavioral health professional
or a behavioral health technician;
4) behavior management services; and 5) psychosocial rehabilitation services (AHCCCS; A.A.C.
R9-22-1205).
AHCCCS must contract for the provision of services for the seriously mentally ill, including: 1) community education to increase public awareness of the needs of persons experiencing behavioral health problems; 2) coordinated screening and intake; 3) a coordinated service delivery system; 4) coordinated case management and individualized treatment planning for each client; 5) ongoing family participation in the planning for and selection of continuum of care services; and 6) comprehensive continuum of care services, as appropriate for each client. (A.R.S. § 36-3407).
Adults with a Serious Mental Illness (SMI) designation, and children designated with a Serious Emotional Disturbance (SED), are also eligible to receive medically necessary mental health and substance use services, even if they are not eligible for AHCCCS. These individuals are often referred to as nontitle XIX SMI or nontitle XXI SED. Funding for these services is provided through the State of Arizona and grants. Examples of these services include but are not limited to: 1) residential treatment; 2) medication; 3) counseling; 4) case management; 5) supportive housing; 6) traditional healing; 7) crisis services; and 8) supportive services (AHCCCS).
Clients who are eligible for nontitle XIX services from AHCCCS must pay fees for services and AHCCCS must establish a schedule for fees charged for services provided by public or private agencies that receive state monies. The schedule of fees must include a sliding fee schedule based on the ability of the client to pay for part or the total cost for services (A.R.S. § 36-3409).
S.B. 1532 appropriates $15,000,000 from the state GF in FY 2026 to AHCCCS.
Provisions
1. Appropriates $15,000,000 from the state GF in FY 2026 to AHCCCS for a 5 percent increase to the outpatient behavioral health fee schedule.
2. Requires AHCCCS to report the actual distribution of rate increases by AHCCCS's contracted health plans to the Joint Legislative Budget Committee by November 15, 2025.
3. Contains a statement of legislative intent.
4. Becomes effective on the general effective date.
Prepared by Senate Research
February 17, 2025
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