What is the Provider Assessment?

Bed Tax

The bed tax is based upon the actual patient days from the UAR (Medicaid Cost Report) on file by 10/31 of each year.  In most cases, facilities are calendared year-end so the 12/31/2018 UAR due 5/31/2019 is the document used to calculate the bed tax for the bed tax year of 10/1/2019 – 9/30/2020.  The tax is based upon all patient days on that filed UAR less Medicare A and any Part C (Managed Medicare) patient days.  The tax rate is either $1.80 per taxable day if your Medicaid patient days qualify for High Volume (It’s a moving target but around 40 – 42K seems to be that number), or $15.63 for any non-high-volume Medicaid facilities. The taxes are due to AZ DOR on 1/20, 4/20, 7/20, and 10/20.

Directed Payment

Currently, each Directed Payment (Formerly Supplemental Payment) represents 100% of the funds collected from the tax with the added FMAP to equal the supplement.  If the Industry does not pay in all their tax, then less money is available in the form of a Directed Payment.  If facilities pay their tax late then those dollars remain in the fund at AZ DOR and are added to the next directed payment.  If the facilities are late on their final payment, then those dollars roll into the new year.  The amount of Directed Payment each facility receives is based upon each facility’s Medicaid Claim Days Paid/The Industry Medicaid Claim Days Paid. This is determined by AHCCCS using data from two years prior. AHCCCS prepares the calculation and submits that to AHCA for review.

Although a facility may provide services to each of the Plans, they may not receive a Directed Payment from each of them.  In order to reduce administrative overhead, any Plan that provides 10% or less of a facility’s total Medicaid days will not be issuing a Directed Payment to that facility.  Instead, those dollars will be given to the Plan that provides the majority of the facility’s Medicaid days.  Since the Directed Payments are strictly passed through from AHCCCS to the facilities using the Plans as an intermediary, this process has no impact on the overall dollars a facility will receive.

Important Dates

Period Tax Due Funds to AHCCCS Payments to MCO Payments to NF
Oct 2019 – Dec 2019 1/20/2020 2/20/2020 2/28/2020 20 Days
Jan 2020 – Mar 2020 4/20/2020 5/15/2020 5/28/2020 20 Days
Apr 2020 – Jun 2020 7/20/2020 8/15/2020 8/28/2020 20 Days
July 2020 – Sep 2020 10/20/2020 11/15/2020 11/28/2020 20 Days

The Oct-Dec period has its tax due on 1/20/2020 to the Dept of Revenue.  The facility should receive a bill to pay.  AHCCCS pulls the funds for matching from the Dept of Revenue on 2/20/2020. AHCCCS then determines how much money each Plan needs to pay and provides the Plans (Managed Care Organizations Mercy Care, United, AHCCCS, Banner) a schedule by 2/28/2020.  Then each of those Plans has 20 days to pay the SNF.

The dates of “Funds to AHCCCS” and “Payments to MCO’s” are estimates.  These dates are approximate but the 20 days from the date of Notification by AHCCCS to the Plans is concrete.  Once AHCA is informed that the MCO’s have been notified, we alert the membership of the directed payment amounts and when to expect their funds.