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A.R.S. § 36-3302

AHCCCS Legislative Approval for Medicaid Waivers

Verified April 4, 202657th Legislature, 1st Regular Session

Arizona requires AHCCCS to get legislative approval before submitting certain Medicaid waiver changes to the federal government. If a waiver would expand eligibility, add new benefits, or raise use by more than ten percent, AHCCCS needs a statute to authorize it first.

Title 36, LIVING WILLS AND HEALTH CARE DIRECTIVES

azleg.gov

What This Statute Controls

Arizona's Medicaid program, AHCCCS, operates under a federal Section 1115 waiver. This waiver lets Arizona design its own health plan.

Any changes to the waiver need federal approval from the Centers for Medicare and Medicaid Services (CMS). This statute adds a state-level check: certain changes also need approval from the Arizona Legislature first.

The administration may not submit to the centers for medicare and medicaid services, or the successor agency, a new amendment proposal for a demonstration waiver under section 1115 of the social security act, or include any new proposed provision in a section 1115 waiver extension, unless the proposed amendment or provision has been authorized by the legislature in the form of a statute.

A.R.S. § 36-3302(A)

The rule applies when the waiver would expand eligibility to new groups, add new covered services, or raise yearly use by more than ten percent.

Why This Matters for Long-Term Care Planning

Changes to Arizona's Medicaid waiver affect who qualifies for coverage and what services are available. If the Legislature must approve expansions, the process stays predictable.

This means families planning around ALTCS eligibility can trust that the rules will not shift without a formal vote.

The statute also includes a monitoring rule. If AHCCCS decides a change does not trigger the requirement, it must track use for three years. If use rises by more than ten percent, AHCCCS must tell legislative leaders.

If the Legislature does not authorize the change within one year, AHCCCS must ask CMS to end it.

Groups and Programs Affected

The waiver covers AHCCCS for many groups, including those at or below the federal poverty level. It also affects programs that serve American Indian and Alaska Native communities.

For families dealing with long-term care costs, the stability this statute provides is real. Eligibility rules and covered services are less likely to shift without public review.

A. The administration may not submit to the centers for medicare and medicaid services, or the successor agency, a new amendment proposal for a demonstration waiver under section 1115 of the social security act, or include any new proposed provision in a section 1115 waiver extension, unless the proposed amendment or provision has been authorized by the legislature in the form of a statute, if the waiver does any of the following: 1. Expands eligibility for title XIX or title XXI coverage to populations not authorized by chapter 29 of this title as of January 1, 2025. 2. Adds new categories of covered services or benefits not authorized by chapter 29 of this title as of January 1, 2025. 3. Will, as a result of the changes being proposed, lead to an annual increase in utilization greater than ten percent for specific services affected by the proposed amendment or provision above what the utilization would have been without the proposed amendment or provision. B. Before submitting a new amendment proposal for a demonstration waiver under section 1115 of the social security act or including a new proposed provision in a waiver extension, the administration shall determine whether the proposed changes are subject to subsection A of this section. Any proposed changes that are subject to subsection A of this section shall be reviewed by the health and human services committees of reference, or their successor committees of reference, and the committees of reference shall forward their recommendation to the senate and house of representatives on whether to approve the proposed changes. C. If the administration determines the proposed changes are not subject to subsection A of this section, the administration shall monitor changes in annual utilization specific to the services impacted by the new waiver changes for three years after the implementation of the changes to determine whether the changes led to an annual increase in utilizatio...

This page provides general legal information about Arizona statutes and is not legal advice. For guidance on how this law applies to your situation, speak with a qualified attorney.

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