Provider Assessment Due – 4/20/2019

The next provider assessment payment is due to the Arizona Department of Revenue (DOR) by 4/20/2019.  The goal is to beat the previous assessment (paid 12/20/2018), which unfortunately amounted to only 83 percent of what we were expecting.  This also resulted in our first set of Directed Payments to be less than we had anticipated.  Our goal each assessment period is to collect $7,446,740 which would generate a Directed Payment to the Providers of $24,666,247. This money is extremely important. Keep in mind that every $1.00 of assessment generates a Directed Payment of $3.28.  Also keep in mind, if you didn’t pay the tax you are in jeopardy of losing your Medicaid dollars altogether.

Next Year’s Provider Assessment (Directed Payments) 10-1-2018 through 9-30-2019

Many of you have been reaching out asking when the new provider assessment calculations will be completed by AHCCCS for the timeframe ending 9-30-19.  Short answer:  They are done. The tax numbers are approved and as always the Directed Payments are estimates… click here.

Long answer: As you know the tax period began 10/1/2018 – 09/30/2019, with the first tax payment due 1/20/2019, based upon the 2017 UARs filed with the ADHS. AHCCCS just finished the provider tax calculations that will be sent to the Arizona Department of Revenue, at which time the first tax bill will be sent to providers.

Now for the primer:  The tax amounts are unchanged and remain at $15.63 per taxable bed day from the 2017 UAR, which constitutes all days minus Medicare and Part C Days for those facilities that do not qualify for high Medicaid volume status or statutory exemption.  For those that qualify for the high volume rate it’ll be $1.80, but keep in mind this is determined by a CMS formula based on total Medicaid days.

Last year we ran into some problems that we worked to avoid this year. AHCCCS did a great deal of work and due diligence to make sure this didn’t occur again.  This includes testing and trending comparisons to avoid any significant problems.  AHCA’s model is expected to be very accurate in terms of the estimated annual tax to be paid by providers. The challenge of the model is that it can only determine the allocation of the Directed Payment to each provider by dividing the Medicaid Days of each facility in the model by the total Medicaid days in the model.  Unfortunately, this percentage can vary from the actual information (adjudicated claims) based upon two years prior. Changes in a provider’s business model could dramatically affect these percentages.  In addition, not all facilities are required to file a UAR but do receive a directed payment (facilities on Indian reservations for instance) based upon their adjudicated claims. Those providers that do not file a UAR are not in the model and therefore would skew the model’s results.  For these reasons, we ask that if you do download the model, please treat the Directed Payment amount as an estimate only.  Stay tuned for more information – we will keep you posted every step of the way.

A2Z Video on Provider Assessment 2018

Provider Assessment June 2018

The SNF Provider Assessment bills were mailed out by DOR on June 22, 2018. Please contact Margaret Asher at the Arizona Department of Revenue (DOR) if you did not receive your invoice.  She can be reached at MAsher@azdor.gov. Remember how important this payment is- if you do not pay the assessment in a timely way, you are subject to DOR fines and penalties and may be at risk of losing your Medicaid provider number. Please check with your business office to make sure that this quarterly DOR provider assessment invoice has been received and will be paid.

Alert SNF Provider Assessment

Several AHCA member centers have alerted us about not receiving their quarterly Department of Revenue tax invoice for the SNF Provider Assessment. Please check to make sure you received your regular quarterly invoice, as it was mailed from DOR on March 23rd and was due on April 20th. If you did not receive this invoice please immediately email:

Margaret Asher
Revenue Auditor, Arizona Department of Revenue
masher@azdor.gov
602-716-6201

AHCA will work with DOR to ensure late fees are waived for those that did not receive the invoice in a timely fashion. It is EXTREMELY IMPORTANT that you get this invoice and make the payment! AHCCCS can only pay you based on the amount that has been paid and in the fund, and if this is lower than expected, our quarterly “return” payments will be less. We are trying to prevent that.

If you have any questions contact me at Dvoepel@azhca.org or our financial consultant Larry Litman at llitman@healthcaresystemsandservices.com.

Reconciliation Payment for SNF Provider Assessment to be Paid

The 5th supplemental SNF provider assessment payment for last fiscal year ending 9-30-16 has been calculated by AHCCCS. AHCA has prepared a list of the payment amounts by Plan by calculating the percentage share in the model. Click here to review our list of the estimated reconciliation payments by Plan. Remember this is a document prepared by AHCA, not AHCCCS and -as always -is our best estimate. It is helpful to understand that this payment is a “truing up” of last year, where the supplemental payments were made at an estimated 80% throughout the year until the state could see the amount of taxes paid at the end of the year. Our calculation is that there was a 98.4 % tax payment to the Department of Revenue this year, which may be a record. With the legislation we ran last year, AHCCCS will have the ability to withhold the Medicaid provider number of those who do not pay this tax in the future, so the penalty for nonpayment will be grave. The Plans received the reconciliation payment from AHCCCS this week and by law, they have 20 days to pass it through to you. If you have questions or problems with this you can contact me at kcpagels@azhca.org.

2015 SNF Provider Reconciliation Payment

AHCCCS has completed the final reconciliation SNF provider assessment payment for the period of 10/1/2014 – 9/30/2015. This is the final and fifth “reconciling” payment of the year, as each of the first four supplemental payments is estimated at 80%.  Here are the results for the reconciliation payment by facility, and what can be expected to be paid by Plan. Remember that AHCCCS pays 100% of their FFS supplement over the four quarters and therefore does not have a reconciliation payment, therefore no one should be expecting any FFS reconciliation payment from AHCCCS.

Arizona Provider Assessment Supplement Correction

As many of you are aware, the 3/31/2015 supplemental payment from AHCCCS that we received did not match exactly to what we were expecting to receive based upon the AHCCCS distribution table online.  After some discussion with AHCCCS, it was determined that a facility had been included in the list to receive a distribution in error.  AHCCCS immediately corrected this and recouped the dollars back from this one Provider. The supplemental payment we all received, although not significantly different was the correct amount that we should have received.  AHCCCS has updated their table so the supplemental dollars allocated now match the dollars sent to each Provider.  The recouped dollars will be given back to the Providers in the form of a reconciliation payment”.

Please click here for the supplement correction.

Victory in Senate Health Committee for SB 1136

I am pleased and grateful to share the good news of our Senate Health Committee hearing! SB 1136, our SNF provider assessment bill passed 5 to 1. The single “no” vote was from Senator Debbie Lesko (R-21). It was an exciting event.. with 80 SNF leaders rallied there to support the bill. We also had 139 individuals signed in on the legislative computer system in support- a record! Thanks so much to each of you for taking the time to attend the hearing and support this critical effort. It was essential that we “filled the room” to hold our lawmakers accountable. Next steps… the bill will go to Senate Rules, and then SB 1136 will soon be voted on by the entire Senate. Then it moves to the House of Representatives, where the process starts all over again! We will have an even greater challenge in the House with all of the newly elected members. Please email your legislators and continue telling your story, one or two paragraphs about why this bill is important to you is best. If you also need to know your legislators where you live or work, call us at the office and we can help. Or go to www.azleg.gov and click on the “find your legislator” section of the opening web page, top left. Things on the political front move very quickly–Stay tuned for future legislative ALERTS!

Click on this link to see SB 1136: https://www.azleg.gov/DocumentsForBill.asp?Bill_Number=1136&Session_Id=114.

Reconciliation Payment for SNF Provider Assessment to be Paid

The 5th supplemental SNF provider assessment payment for last fiscal year ending 9-30-16 has been calculated by AHCCCS. AHCA has prepared a list of the payment amounts by Plan by calculating the percentage share in the model. Click here to review our list of the estimated reconciliation payments by Plan. Remember this is a document prepared by AHCA, not AHCCCS and -as always -is our best estimate. It is helpful to understand that this payment is a “truing up” of last year, where the supplemental payments were made at an estimated 80% throughout the year until the state could see the amount of taxes paid at the end of the year. Our calculation is that there was a 98.4 % tax payment to the Department of Revenue this year, which may be a record. With the legislation we ran last year, AHCCCS will have the ability to withhold the Medicaid provider number of those who do not pay this tax in the future, so the penalty for nonpayment will be grave. The Plans received the reconciliation payment from AHCCCS this week and by law, they have 20 days to pass it through to you. If you have questions or problems with this you can contact me at kcpagels@azhca.org.

Arizona Provider Assessment Supplement Correction

As many of you are aware, the 3/31/2015 supplemental payment from AHCCCS that we received did not match exactly to what we were expecting to receive based upon the AHCCCS distribution table online.  After some discussion with AHCCCS, it was determined that a facility had been included in the list to receive a distribution in error.  AHCCCS immediately corrected this and recouped the dollars back from this one Provider. The supplemental payment we all received, although not significantly different was the correct amount that we should have received.  AHCCCS has updated their table so the supplemental dollars allocated now match the dollars sent to each Provider.  The recouped dollars will be given back to the Providers in the form of a reconciliation payment.”

Please click here for the supplement correction.

SNF Provider Assessment Reconciliation Amounts Posted

Late Monday, 12/22/2014, AHCA Executive Director, Kathleen Collins Pagels, received the amounts for the “5th quarterly” supplemental payments, which is the annual reconciliation, closing out this the 2013/2014 provider assessment year. Remember, your first four quarterly supplemental payments, were based on 80% payment estimate, thus this 5th reconciliation supplemental payment, now that AHCCCS has received confirmation of all provider taxes paid into DOR. To find your reconciliation amounts by Plan, please click here:

Provider Assessment Update- 12/22/2014

  • AHCA has prepared a working model of the 2014/15 SNF provider assessment with estimated tax to be paid and estimated supplemental payment (in total) to be returned in the year ahead. Remember, it is just an estimate on all sides. The state can only pay out in supplemental payments what is paid in taxes. To find your estimated tax amounts and estimated payout in the AHCA model, please click here. NOTE: REMEMBER, this is not an official model provided by the state, but our own here at AHCA, one we believe to constitute “best estimates”.
  • A few things to remember. First, the Plan payments are “supplemental payments” directed by AHCCCS and are returned to you at 80% quarterly. The 5th quarterly check is really an annual “reconciliation” for the year- depending upon what is paid into the Department of Revenue to constituting the remaining 20%. If questions about how this works email me at kcpagels@azhca.org or AHCA financial consultant Larry Litman at llitman@healthcaresystemsandservices.com.
  • The annual reconciliation amounts should be posted very shortly, within days. When those amounts are available, I will send an ALERT so you can know what to expect for this “5th” reconciliation check.
  • You are hopefully aware of the AHCCCS rule change that went into effect, changing the tax rates from $7.50 per day to $10.50 per day (and from $1.00 to $1.40 per day for high volume Medicaid facilities based on the federal formula). I have mentioned this in several past AHCA Updates. Just want to make sure this is not a surprise when you receive your tax bill. This was requested by members in order to increase the supplemental payment returns commensurately.
  • We are running legislation in 2015 to remove the “sunset” or end date of the provider assessment and $63 million is at stake. I will be asking for your help every step of the way. We will be also adding more strict penalties to the law for non-payment of the tax (which we hope will include loss of Medicaid provider registration for non- payment.)
  • Save the date for an AZ SNF Provider Assessment webinar to discuss all of the above on Friday, January 16th at 11 am. Thanks!!

Reconciliation 2013

Reconciliation 2013
The attached PDF is the information provided by AHCCCS specifying the final 2013 SNF Provider Assessment Reconciliation provider payments by Plan. If questions, contact Kathleen Collins Pagels at kcpagels@azhca.org. 12/20/13

The Plans received their capitation payments for the provider assessment on February 14th and they have 30 days to get the payments to you so you will receive your first quarterly 2014 payment (for Oct-Dec 2013 ) by March 14th, or before. The Plans have all been very timely with provider assessment payments in the past year (thank you Plans!), so if its payment is not received – check with your Plan provider representative and if that fails, please contact me.

AHCCCS has announced a correction in the 2013 final reconciliation. The additional amount of funds to be distributed to SNFs is $492,568.83. Click on this link to see the number of payments by Plan that you can expect to receive. Remember, this will come at or about the same time as your first quarterly 2014 payment, March 14th, but they are separate! The 2nd reconciliation correction payment will be much smaller than your first quarterly payment as it represents a portion of what should have been paid in the final 2013 reconciliation. The good news is that the error was in our favor!

SNF Provider Assessment Rule

SNF Provider Assessment Rule

We are working with AHCCCS to revise the rule governing the implementation of the SNF provider assessment. Here is the link to the current rule. https://www.azahcccs.gov/reporting/Downloads/UnpublishedRules/NOFR111314.pdf. Note that the “strike out” language indicates current revisions being made but not those that are under discussion at this point. We would like to increase the amount of tax paid, and commensurately the return to you as providers. The rule change we desire will increase the tax paid from $7.50 per day to $10.50 per day for 2015. The “high volume” tax payment would increase from $1.00 to $1.40. This will increase your payments as well if we are successful with the rule change. We will also be clarifying that the “high volume” determination will be based on a formula from the SNF UAR, rather than claims and encounter data as it was interpreted this year. This is a 9-month process for rule revision and we will keep you posted on our efforts. I will also be presenting on the provider assessment with Larry Litman at the Spring Leadership conference so please be sure to attend. The dates for the event are April 28-29 in Tucson- a registration brochure will be out soon.