AHCCCS; redeterminations; eligibility verification; report

Plain English Breakdown

The bill summary and text do not provide specific details on how eligibility verification will be conducted or what happens if an individual's eligibility changes between checks.

AHCCCS; Redeterminations and Eligibility Verification

This bill requires AHCCCS to verify eligibility every six months for adults aged 21 or older, starting January 1, 2027, and to report certain data annually.

What This Bill Does

• Requires AHCCCS to check the continued eligibility of adults who are at least 21 years old every six months beginning January 1, 2027.
• Requires AHCCCS to use available data sources for verifying eligibility instead of asking beneficiaries directly whenever possible.
• Requires AHCCCS to report specific numbers about new applications and verifications annually by December 1st.

Who It Names or Affects

• Adults aged 21 or older who are enrolled in AHCCCS programs.
• AHCCCS, the agency that administers Arizona's Medicaid program.

Terms To Know

AHCCCS

Arizona Health Care Cost Containment System, which is Arizona’s Medicaid program.

Eligibility verification

The process of checking if someone meets the requirements to receive benefits from a government program like AHCCCS.

Limits and Unknowns

• Does not specify how often eligibility must be verified for individuals under age 21.
• Does not provide details on what happens if an individual's eligibility changes between checks.
• The bill does not include any fiscal impact to the state General Fund.

Official Summary Text

SB1398 - 572R - Senate Fact Sheet

Assigned to
HHS������������������������������������������������������������������������������������������������ AS
PASSED BY COMMITTEE

ARIZONA STATE SENATE

Fifty-Seventh
Legislature, Second Regular Session

AMENDED

FACT SHEET FOR
s.b. 1398

AHCCCS;
redeterminations; eligibility verification; report

Purpose

Requires the Arizona Health Care Cost Containment System (AHCCCS) to
determine the continued eligibility of adults who are at least 21 years old at
least once every six months and prescribes related reporting requirements.

Background

The Arizona Health Care Cost Containment System (AHCCCS) administers
Arizona�s Medicaid program and determines eligibility for coverage based on
federal and state requirements. AHCCCS is responsible for verifying applicant
information, enrolling eligible individuals and periodically redetermining
member eligibility to ensure continued compliance with program criteria (
A.R.S. � 36-2903
).

Under federal law, state Medicaid agencies must renew eligibility for
most beneficiaries at least once every 12 months and may not conduct renewals
more frequently than that interval except in limited circumstances. States must
attempt to verify eligibility using available data sources before requesting
information from the beneficiary and must redetermine eligibility whenever they
receive information indicating a potential change in circumstances that could
affect eligibility (
42
C.F.R. � 435.916
).

There is no anticipated fiscal impact to the state General Fund
associated with this legislation.

Provisions

1.

Requires
AHCCCS, beginning January 1, 2027, to redetermine the eligibility of any adult
member who is at least 21 years old at least every six months.

2.

Requires
AHCCCS, by December 1 of each year, to report to the Joint Legislative Budget
Committee, Governor, President of the Senate, Speaker of the House of
Representatives (House) and members of the Senate and House Health and Human
Services Committees, or their successor committees, all of the following:

a)

the number of new eligibility applications for enrollment received in
the previous contract year;

b)

the number of eligibility verifications completed in the previous
contract year;

c)

the number of applications received in the previous contract year for
enrollment in an AHCCCS program that requires asset verification as part of the
eligibility process; and

d)

the number of asset verifications completed in the previous contract
year.

3.

Becomes
effective on the general effective date.

Amendments
Adopted by Committee

�

Makes technical changes.

Senate Action

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Prepared by Senate Research

February 20, 2026

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Current Bill Text

SB1398 - 572R - S Ver

Senate Engrossed

AHCCCS;
redeterminations; eligibility verification; report

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SENATE BILL 1398

AN
ACT

Amending title 36, chapter 29, article 1,
Arizona Revised Statutes, by adding section 36-2929.01; relating to the
Arizona health care cost containment system.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it
enacted by the Legislature of the State of Arizona:

Section
1.
1. Title
36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding
section 36-2929.01, to read:

START_STATUTE
36-2929.01.

Redeterminations; eligibility verification; annual report

A. Beginning January 1, 2027,
notwithstanding any other provision of this article to the contrary, at least
every six months the administration shall determine the continued eligibility
of any adult who is at least twenty-one years of age.� The administration
shall verify eligibility using available data.

B. On or before December 1 of each
year, the administration shall annually report to the joint legislative budget
committee, the governor, the president of the senate, the speaker of the House
of representatives and the members of the senate and house of representatives
health and human services committees, or their successor committees,
all of the following:

1. The number of new eligibility
applications for enrollment in the system that were received in the previous
contract year.

2. The number of eligibility
verifications for enrollment in the system that were completed in the previous
contract year.

3. The number of applications
received in the previous contract year for enrollment in a program administered
by the administration that requires an asset verification as part of the
eligibility process.

4. The number of asset verifications
that were completed in the previous contract year.
END_STATUTE