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ALTCS; providers; change of ownership, the official text

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House Engrossed
Senate Bill

ALTCS; providers;
change of ownership

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SENATE BILL 1164

AN
ACT

Amending section 36-2943, Arizona
Revised Statutes; relating to the Arizona long-term care system.

(TEXT OF BILL BEGINS ON NEXT PAGE)

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

Section 1. Section 36-2943, Arizona Revised
Statutes, is amended to read:

START_STATUTE36-2943. Provider
subcontracts; hospital reimbursement; change of ownership

A. Subcontracts for services rendered by providers
pursuant to section 36-2940 shall be awarded through competitive
statewide proposals in as nearly the same manner as that provided in section 41-2534. If
there is not a sufficient number of qualified proposals, a subcontract may be
negotiated with a provider and shall be awarded pursuant to section 41-2536. In
order to deliver covered services to members who are enrolled
or expected to be enrolled in the system within a county, the program
contractor may negotiate and award without bid a provider subcontract if during
the contract year there is an insufficient number of subcontracts awarded to
providers. The term of the subcontract shall not extend beyond the
next bid and subcontract award process as provided in this section, and the
subcontract shall be at rates no greater than the weighted average rates for
the appropriate level of care paid to similar providers in the same
county. This section does not allow a program contractor to forego forgo the competitive bid process
pursuant to section 41-2534 unless there is an unanticipated increase in
members enrolled in the system or a decrease in available beds brought about by
the closure of a facility operated by a provider that is unable to be absorbed
by current contracting providers located in the same general area. Before
soliciting subcontracts without the competitive bid process, the program
contractor shall receive approval from the director.

B. Hospitals that render care to members shall be
paid by the program contractor as prescribed in section 36-2903.01, or [such] at a lower
rate as may be negotiated by the program contractor.

C. The director may ensure through the subcontracts
pursuant to subsection A of this section that at least ten [per
cent] percent of the members are provided services
pursuant to this article on a capitation basis.

D. A claim for an authorized service submitted by a
licensed skilled nursing facility, an assisted living Arizona long-term care
system provider or a home and community based Arizona long-term care system
provider that renders care to members pursuant to this article shall be
adjudicated within thirty calendar days after receipt by the program
contractor. Any clean claim for an authorized service provided to a
member that is not paid within thirty calendar days after the claim is received
accrues interest at the rate of one [per cent] percent per month from the date the claim is submitted. The
interest is prorated on a daily basis and must be paid by the program
contractor at the time the clean claim is paid.

E. Notwithstanding any other
provision of this chapter to the contrary, when there is a change of ownership
of a licensed skilled nursing facility or an assisted living facility that is NOT IN A SUSPENSION, TERMINATION OR PAYMENT HOLD, THAT HAS AN ACTIVE
PROVIDER ENROLLMENT WITH THE ADMINISTRATION and that continues to provide
services under this article, at the new owner's request the administration and
its program contractors shall continue to process claims for SERVICEs rendered
to members and make payments in accordance with subsection D of this section
under the previous owner's aRIZONA HEALTH CARE COST
CONTAINMENT SYSTEM number and subcontracts until the new owner's system
enrollment and contracting process is completed.  tHE
CURRENT OWNER OR NEW OWNER SHALL PROVIDE WRITTEN NOTICE TO THE ADMINISTRATION
AT LEAST SIXTY DAYS BEFORE AN ANTICIPATED CHANGE OF OWNERSHIP and respond to
all provider enrollment requests within ten business days.
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