AHCCCS could soon run out of money and would no longer be able to pay their contracted health plans for the services they’ve been providing to Medicaid members. How is that happening, you ask?
About a month ago HB 2624 was signed into law giving AHCCCS expenditure authority for half of the $3B AHCCCS has already received from the feds this fiscal year.
That money is intended to cover formula adjustments in the capitation rates for the Managed Care Organizations who contract with AHCCCS. The bill was passed with the understanding that the remaining 50% would be approved as part of continuing budget negotiations.
That subsequent approval hasn’t happened yet – hence the anxiety about how AHCCCS is going to be able to pay their bills the rest of this fiscal year. Without the remaining expenditure authority approved by the Legislature, AHCCCS will need to delay the May monthly capitation payments to their contracted Managed Care Organizations.
In the interim, this delay means the Agency and the State are unable to meet those payment obligations, resulting in instability for Arizona’s business community, private partners and any local organizations that rely on funding from the MCOs.
Note: This legislative effort just seeks the authority to spend federal monies (i.e., zero dollars from the state general fund).
Will a fix happen before May comes? We’ll see. Right now, it appears the majority in the legislature is content to let AHCCCS’ contractors provide care ‘on the house’. We should know soon.
