appropriation; behavioral health provider rates

Plain English Breakdown

The bill summary does not provide details about how the increased reimbursement rates will be distributed among different types of behavioral health services.

Behavioral Health Provider Rate Increase

This bill provides $60 million from the state's general fund for a 10 percent increase in reimbursement rates for behavioral health services to Medicaid providers.

What This Bill Does

• Appropriates $60,000,000 from the state General Fund to AHCCCS (Arizona Health Care Cost Containment System) for a 10% rate increase for behavioral health services.
• Requires this rate increase to be added on top of existing rates and passed through fully to providers without being offset by other negotiated rates.
• Limits reimbursement increases to comply with federal upper payment limits set by the Centers for Medicare and Medicaid Services (CMS).
• Specifies that these funds can only be used for behavioral health provider reimbursements, not for administrative costs or other services.

Who It Names or Affects

• Behavioral health providers who receive reimbursement from AHCCCS.
• Medicaid recipients in Arizona who will benefit from increased access to behavioral health services due to higher provider rates.

Terms To Know

AHCCCS

Arizona Health Care Cost Containment System, which is the state's Medicaid agency.

Reimbursement Rate Increase

An increase in the amount of money paid to healthcare providers for services covered by Medicaid.

Limits and Unknowns

• The bill does not specify how the increased reimbursement rates will be distributed among different types of behavioral health services.
• It is unclear if there are any provisions for monitoring or evaluating the impact of this rate increase on provider capacity and patient access to care.

Official Summary Text

SB1451 - 572R - Senate Fact Sheet

Assigned to
HHS
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COMMITTEE

ARIZONA STATE SENATE

Fifty-Seventh
Legislature, Second Regular Session

FACT SHEET FOR
S.B. 1451

appropriation; behavioral
health provider rates

Purpose

Appropriates
$60,000,000 from the state General Fund (state GF) in FY 2027 to the Arizona
Health Care Cost Containment System (AHCCCS) to provide a 10 percent
reimbursement rate increase for behavioral health services to Medicaid
providers and prescribes requirements for the distribution of monies.

Background

AHCCCS serves as
Arizona's Medicaid agency, which offers qualifying Arizona residents access to
healthcare programs, including behavioral health. AHCCCS contracts with health
professionals to provide medically necessary health and medical services to eligible
members. AHCCCS provides both inpatient and outpatient behavioral health
services, including but not limited to: 1) all behavioral health services,
medical detoxification, accommodations and staffing, supplies and equipment, if
provided under the direction of a physician of a Medicare-certified, inpatient
facility; 2) screenings provided by a behavioral health professional or
technician; 3) a behavioral health assessment provided by a behavioral health
professional or technician; 4) counseling, including individual therapy, group
therapy and family therapy provided by a behavioral health professional or
technician; 5) behavior management services; and 6) psychosocial rehabilitation
services (
A.R.S.
� 36-2907
;
A.A.C.
R9-22-1205
).

A
capped
fee-for-service
is the payment mechanism by which a provider of care is
reimbursed upon submission of a valid claim for a specific covered service or
equipment provided to a member. A payment is made in accordance with an upper
or capped limit established by the Director of AHCCCS and may either be a
specific dollar amount or a percentage of billed charges. AHCCCS must pay
providers, including both contracting and noncontracting providers, at either
the lesser of billed charges or outlined capped fee-for-service rates, unless a
different fee is specified in a contract between AHCCCS and the provider, or is
otherwise required by law (A.A.C.
R9-22-101

and
R9-22-710
).

S.B. 1451
appropriates $60,000,000 from the state GF in FY 2027 to AHCCCS.

Provisions

1.

Appropriates $60,000,000 from the state GF in FY 2027 to AHCCCS for the
purpose of providing a 10 percent reimbursement rate increase for inpatient and
outpatient behavioral health services to Medicaid providers.

2.

Specifies that the reimbursement rate must be applied as an increase to
the provider reimbursement rate and in addition to any existing or previously
negotiated reimbursement rates paid by AHCCCS or any contracted Medicaid health
plan.

3.

Prohibits a contracted Medicaid health plan from offsetting, supplanting
or otherwise absorbing the reimbursement rate increase by relying on existing
negotiated rates that exceed the AHCCCS fee-for-service reimbursement rates.

4.

Requires the full reimbursement rate increase to be passed through to
behavioral health providers.

5.

Prohibits the reimbursement rate increases from exceeding applicable U.S.
Centers for Medicare and Medicaid Services upper payment limits.

6.

Stipulates
that the appropriated monies:

a)

must be used solely for Medicaid behavioral health provider
reimbursement rate increases for inpatient and outpatient services; and

b)

may
not be reallocated, transferred or used to fund other service categories,
administrative costs or programmatic purposes.

7.

Becomes effective on the general effective date.

Prepared by Senate Research

February 9, 2026

MM/SDR/hk

Current Bill Text

SB1451 - 572R - I Ver

REFERENCE TITLE:
appropriation; behavioral health provider rates

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SB 1451

Introduced by

Senator
Shope

AN
ACT

Appropriating monies 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.
Appropriation;
Arizona health care cost containment system; behavioral health providers;
reimbursement rate increase

A. The sum of $60,000,000
is appropriated from the state general fund in fiscal year 2026-2027 to the
Arizona health care cost containment system for the purpose of providing a ten
percent reimbursement rate increase for inpatient and outpatient behavioral
health services to medicaid providers.

B. The reimbursement rate
increase prescribed in subsection A of this section shall be applied as an
increase to the provider reimbursement rates and is in addition to any existing
or previously negotiated reimbursement rates paid by the Arizona health care
cost containment system or any contracted medicaid health plan.

C. A contracted medicaid
health plan may not offset, supplant or otherwise absorb the reimbursement rate
increase prescribed in subsection A of this section by relying on existing
negotiated rates that exceed the Arizona health care cost containment system
fee-for-service reimbursement rates. The full reimbursement rate
increase shall be passed through to behavioral health providers.

D. Reimbursement rate
increases implemented pursuant to this section may not exceed applicable
centers for medicare and medicaid services upper payment limits.

E. Monies appropriated
pursuant to subsection A of this section shall be used solely for medicaid
behavioral health provider reimbursement rate increases for inpatient and
outpatient services and may not be reallocated, transferred or used to fund
other service categories, administrative costs or programmatic purposes.