AHCCCS has broad authority to exclude participating providers from its program. For example, AHCCCS may terminate a provider’s AHCCCS participation agreement if the provider fails to comply with their provider participation agreement, or with federal and state laws, rules, or regulations. AHCCCS must also suspend payments pending an investigation of a “credible allegation of fraud”…
Concurrent with the Covid-19 Public Health Emergency (“PHE”), the Arizona Health Care Cost Containment System (“AHCCCS”) modified requirements related to member enrollment and provider revalidation. Following the Consolidated Appropriations Act of December 2022, Medicaid is decreasing specific additional funding made available during the PHE. As a result, AHCCCS has returned to the regular renewal process…
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