The proposed bill would update the Arizona Health Care Cost Containment System (AHCCCS) statutes by introducing new enrollment verification requirements and modifying the presumptive eligibility process. Specifically, it would mandate AHCCCS to enter into data matching agreements with the Department of Revenue to identify members with lottery or gambling winnings of $3,000 or more, requiring monthly reviews of this information. Additionally, the bill would require regular reviews of death records and changes in members' circumstances affecting eligibility, while prohibiting self-attestation of key eligibility factors without independent verification.

Moreover, the bill would eliminate mandatory hospital presumptive eligibility for most individuals, limiting it to children and pregnant women, and would require qualified hospitals to notify AHCCCS of presumptive eligibility determinations within five working days. It establishes standards for these determinations and a compliance framework, including mandatory training for hospitals that fail to meet the standards. The act is set to take effect after December 31, 2026, aiming to enhance the integrity and efficiency of the AHCCCS eligibility process.

Statutes affected:
Introduced Version: 36-2903.18, 36-2903.19