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Provider Assessment

What is the Provider Assessment?

Bed Tax or Provider Assessment

The provider assessment, commonly referred to as the bed tax is based upon the actual patient days from the UAR (Medicaid Cost Report) that is filed by each facility by the end of May of each year.  In most cases, facilities are calendared year-end so the December 31 UAR due May 31 is the document used to calculate the bed tax for the bed tax year of October 1 through September 30 of the following year.  The assessment is based upon all patient days filed on the UAR less Medicare A and any Part C (Managed Medicare) patient days.  The tax rate is either $2.40 per taxable day if your Medicaid patient days qualify for High Volume, or $20.80 for any non-high-volume Medicaid facilities. High Volume is a moving target every year, but since COVID the cut line has been in the lower 30,000s. 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 (federal match) to equal the supplement.  If a facility does not pay in all their tax, then less money is available to everyone.  If facilities pay their tax late then those dollars remain in the fund at AZ DOR and are added to the next payment.  If the facilities are late on their final payment, then those dollars roll into the new year.  The amount of payment each facility receives is based upon each facility’s Medicaid Claim Days Paid/The Total SNF 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 an assessment 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 an assessment 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 assessment 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 – Dec 1/20 2/20 2/28 20 Days
Jan – Mar 4/20 5/15 5/28 20 Days
Apr – Jun 7/20 8/15 8/28 20 Days
July – Sep 10/20 11/15 11/28 20 Days

The Oct-Dec period has its tax due on January 20 of the following year directly to the AZ Dept of Revenue.  The facility should have received one initial annual bill from ADOR and then that total amount can be broken down by fourths to pay quarterly. AHCCCS pulls the funds from the Dept of Revenue on 2/20. AHCCCS then determines how much money each Plan needs to pay and provides the Plans schedule by 2/28.  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 through the weekly newsletter.