Current through Register Vol. 30, No. 38, September 20, 2024
A. For purposes of
this Article:
1. A copayment is a monetary
amount that a member pays directly to a provider at the time a covered service
is rendered.
2. An eligible
individual is assigned to a hierarchy established in subsections (B) through
(E), for the purposes of establishing a copayment amount.
3. No refunds shall be made for a retroactive
period if there is a change in an individual's status that alters the amount of
a copayment.
B. The
following services are exempt from AHCCCS copayments for all members:
1. Family planning services and
supplies,
2. Services related to a
pregnancy or any other medical condition that may complicate the pregnancy,
including tobacco cessation treatment for a pregnant woman,
3. Emergency services as described in
42 CFR
447.56(2)(i),
4. All services paid on a fee-for-service
basis,
5. Preventive services, such
as well visits, immunizations, pap smears, colonoscopies, and
mammograms,
6. Provider preventable
services.
C. The
following individuals are exempt from AHCCCS copayments:
1. An individual under age 19, including
individuals eligible for the KidsCare Program in A.R.S. §
36-2982;
2. An individual
determined to be Seriously Mentally Ill (SMI) by the Arizona Department of
Health Services;
3. An individual
eligible for the Arizona Long-Term Care Program in A.R.S. §
36-2931;
4. An individual eligible
for QMB under Chapter 29;
5. An
individual eligible for the Children's Rehabilitative Services program under
A.R.S. § 36-2906(E);
6. An
individual receiving nursing facility or HCBS services under
R9-22-216;
7. An individual
receiving hospice care as defined in
42 U.S.C.
1396d(o);
8. An American Indian individual enrolled in
a health plan and has received services through an IHS facility, tribal 638
facility or urban Indian health program;
9. An individual eligible in the Breast and
Cervical Cancer program as described under Article 20;
10. An individual who is pregnant including
the postpartum period which is the last day of the month in which the 60th day
following the date the pregnancy ends;
11. An individual with respect to whom child
welfare services are made available under Part B of Title IV of the Social
Security Act on the basis of being a child in foster care, without regard to
age;
12. An individual with respect
to whom adoption or foster care assistance is made available under Part E of
Title IV of the Social Security Act, without regard to age; and
13. An adult eligible under R9-22-1427(E),
with income at or below 106% of the FPL.
D. Non-mandatory copayments. Unless otherwise
listed in subsection (B) or (C), individuals under subsections (D)(1) through
(6) are subject to the copayments listed in this subsection. A provider shall
not deny a service when a member states to the provider an inability to pay a
copayment.
1. A caretaker relative eligible
under R9-22-1427(A);
2. An
individual eligible for Young Adult Transitional Insurance (YATI) in A.R.S.
§ 36-2901(6)(a)(iii);
3. An
individual eligible for State Adoption Assistance in R9-22-1433;
4. An individual eligible for Supplemental
Security Income (SSI);
5. An
individual eligible for SSI Medical Assistance Only (SSI/MAO) in Article 15;
and
6. An individual eligible for
the Freedom to Work program in A.R.S. § 36-2901(6)(g).
7. Copayment amount per service:
a. $2.30 per prescription drug.
b. $3.40 per outpatient visit, excluding an
emergency room visit, if any of the services rendered during the visit are
coded as evaluation and management services or non-emergent surgical procedures
according to the National Standard Code Sets. An outpatient visit includes any
setting where these services are performed such as a physician's office, an
Ambulatory Surgical Center (ASC), or a clinic.
c. $2.30 per visit, if a copayment is not
being imposed under subsection (D)(7)(b) and any of the services rendered
during the visit are coded as physical, occupational or speech therapy services
according to the National Standard Code Sets.
E. Mandatory copayments.
1. Copayments for individuals eligible for
Transitional Medical Assistance (TMA) under R9-22-1427(B)(1)(c)(i). Unless
otherwise listed in subsection (C), an individual is required to pay the
following copayments for prescription drugs and outpatient services unless the
service is provided during an emergency room visit or the service is otherwise
exempt under subsection (B). An outpatient visit includes any setting where
these outpatient services are performed such as, an outpatient hospital, a
physician's provider's office, HCBS setting, an Ambulatory Surgical Center
(ASC), or a clinic:
a. $2.30 per prescription
drug.
b. $4.00 per outpatient
visit, if any of the services rendered during the visit are coded as evaluation
and management services according to the National Standard Code Sets.
c. If a copayment is not being imposed under
subsection (E)(1)(b), $3.00 per visit if any of the services rendered during
the visit are coded as physical, occupational or speech therapy services
according to the National Standard Code Sets.
d. If a copayment is not being imposed under
subsection (E)(1)(b) or (c), $3.00 per visit, if any of the services rendered
during the visit are coded as non-emergent surgical procedures according to the
National Standard Code Sets.
2. Copayments for persons eligible under
R9-22-1427(E) with income above 106% of the FPL and for persons eligible under
A.R.S. §§ 36-2907.10 and 36-2907.11. Subject to CMS approval, unless
otherwise listed in subsection (C), these individuals are required to pay the
following copayments for prescription drugs and outpatient services unless the
service is provided during an emergency room visit or the service is otherwise
exempt under subsection (B). An outpatient visit includes any setting where
these outpatient services are performed such as, an outpatient hospital, a
physician's provider's office, HCBS setting, an Ambulatory Surgical Center
(ASC), or a clinic:
a. $4.00 per prescription
drug.
b. $5.00 per outpatient visit
when the AHCCCS fee schedule for the visit code is a rate from $50 to less than
$100, if any of the services rendered during the visit are coded as evaluation
and management services according to the National Standard Code Sets.
c. $10.00 per outpatient visit when the
AHCCCS fee schedule for the visit code is a rate of $100 or greater, if any of
the services rendered during the visit are coded as evaluation and management
services according to the National Standard Code Sets.
d. If a copayment is not being imposed under
subsection (E)(2)(b) or (E)(2)(c), for services coded as physical, occupational
or speech therapy services according to the National Standard Code Sets.
i. $2.00 if the rate on the fee schedule is
$20 to $39.99,
ii. $4.00 if the
rate on the fee schedule is $40 to $49.99, or
iii. $5.00 if the rate on the fee schedule is
$50 and above per visit.
e. If a copayment is not being imposed under
subsection (E)(2)(b) -(E)(2)(d), for services coded as non-emergent surgical
procedures according to the National Standard Code Sets,
i. $30.00 if the rate on the fee schedule is
$300 to $499.99, or
ii. $50.00 if
the rate on the fee schedule is $500 and above per visit.
f. Unless the individual is otherwise exempt
in subsection (C) or the service is exempted under subsection (B) the
individual is required to pay $2.00 per trip for non-emergency transportation
in an urban area.
g. Unless the
individual is otherwise exempt in subsection (C) or the service is exempted
under subsection (B) the individual is required to pay $8.00 for non-emergency
use of the emergency room.
h.
Unless the individual is otherwise exempt in subsection (C) or the service is
exempted under subsection (B) the individual is required to pay $75 for an
Inpatient stay.
3. The
provider may deny a service if the member does not pay the copayment required
by subsection (E), however, a provider may choose to reduce or waive copayments
under this subsection on a case-by-case basis.
F. A provider is responsible for collecting
any copayment imposed under this Section.
G. The total aggregate amount of copayments
under subsections (D) or (E) may not exceed 5% of the family's income as
applied on a quarterly basis. The member may establish that the aggregate limit
has been met on a quarterly basis by providing the Administration with records
of copayments incurred during the quarter. In addition, the Administration
shall also use claims and encounters information available to the
Administration to establish when a member's copayment obligation has reached 5%
of the family's income.
H.
Reduction in payments to providers. The Administration and its contractors
shall reduce the payment it makes to any provider by the amount of a member's
copayment obligation under subsection (E), regardless of whether the provider
successfully collects the copayments described in this Section.