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Connection Newsletter - opening day for the Arizona legislature, updated regulatory guidance and the latest in hospital finances

Read more about this week’s health news highlights for the Arizona healthcare community in the Connection newsletter. 

56th Arizona Legislature convenes Monday

Monday, Jan. 9 marks the opening day for the 56th Arizona Legislature, First Regular Session. It is a day of much pomp and circumstance, but it also marks a nearly 50% turnover in our state legislative chambers where an incredible number of new legislators will be sworn in to serve their legislative districts. There are set to be 30 new members in the House and 16 new members in the Senate—more than half of the legislature turned over this election cycle. Governor Katie Hobbs will also deliver her first State of the State address to a joint session of the Arizona House and Senate on Monday morning. Stay tuned for a summary of the State of the State in next week’s Connection newsletter. AzHHA’s weekly member-only legislative update calls will kick off next Friday, Jan. 13 as well. For more information on those calls, reach out to AzHHA Director of Government Relations, Meghan McCabe.

Updated regulatory guidance for “exceeding licensed capacity”

The Arizona Department of Health Services (ADHS) has updated its frequently asked questions for actions that hospitals can take to address surge capacity in the absence of a declared state of public health emergency and state regulatory waivers. ADHS has added two FAQs to the guidance document explaining that hospitals experiencing overcapacity can attempt to transfer the patient out even if the hospital has the clinical capability to care for the patient. Such a transfer request would not be a violation under EMTALA. In addition, ADHS clarified that a receiving facility may not request insurance information prior to accepting an appropriate EMTALA-covered transfer.

Medicaid redeterminations to start on April 1

Included in the omnibus bill signed by President Biden last week is a provision that permits states to begin Medicaid redetermination efforts beginning April 1, 2023. Since the beginning of the public health emergency (PHE), states have received an additional 6.2 percentage point increase in the federal Medicaid matching rate, but in return, they have been unable to disenroll individuals from Medicaid regardless of a change in eligibility. While the omnibus bill did not end the PHE, states will have one year to complete redeterminations. Based on previous conversations with the Arizona Health Care Cost Containment System (AHCCCS), it is our understanding that as many as 600,000 of the 2.5 million currently enrolled AHCCCS members may lose eligibility over the coming year. Healthcare providers can help get the word out that AHCCCS members will want to ensure that their mailing address, phone number and email address are up-to-date on and that AHCCCS members respond to requests from AHCCCS for more information. Additional information is available on AHCCCS’ website.

In addition to allowing states to perform redeterminations, the omnibus bill phases out the 6.2 percentage point enhanced federal match. Beginning on April 1, the enhanced match will drop to 5 percentage points and continue to drop each quarter until it is eliminated on Jan. 1, 2024.

CMS issues No Surprises Act FAQs on good faith estimates

Last week the Centers for Medicare and Medicaid Services (CMS) issued its fourth installment of FAQs on good faith estimates for uninsured individuals and self-pay individuals. It answers questions on how providers who offer sliding fee scales or who do not plan to bill can comply with good faith estimate (GFE) requirements, whether abbreviated GFEs can be subject to the Patient-Provider Dispute Resolution Process and the types of contact information should be included in a GFE.

AIM bundle update

Recently, the National Alliance for Innovation on Maternal Health (AIM) added new measures to the Hypertension Bundle. Due to the changes, Arizona will continue to focus on improving hypertensive treatment. Arizona hospitals will now have more time to improve their metrics and knock the Hypertension Bundle goals out of the park! The annual AIM Collaborative Conference, on Sept. 15, 2023, will mark the in-person kickoff of the AIM Hemorrhage Bundle.

November hospital finances

On Wednesday, KaufmanHall released its report on November hospital finances which shows data from more than 900 hospitals nationwide. While hospital operating margins have improved slightly, year-to-date hospital margins continue to remain negative at -0.2%. Both hospital expenses and labor expenses decreased slightly in November, helping hospital margins. Additionally, hospital outpatient revenue is up this year which is helping to boost lower inpatient revenues. AzHHA Staff continues to monitor Arizona hospital revenue and look forward to reporting more Arizona-specific details in our upcoming Quarterly Financial Analysis. The 2022 fourth-quarter report should be available in approximately one month.

AzHHA’s year in review

AzHHA’s steadfast advocacy on behalf of Arizona hospitals permeated the year as we worked to advance health and healthcare in Arizona. Our 2022 Annual Report highlights the “wins” we celebrate on behalf of Arizona hospitals and the necessary investments in strengthening our healthcare workforce. Download a copy of the 2022 Annual Report here

January is National Human Trafficking Prevention Month

As we prepare for several high-profile events coming to our state, hospitals, health systems and clinicians will likely find themselves experiencing elevated interactions and on the front lines of care for victims of human trafficking and forced labor. AzHHA, in partnership with the American Hospital Association (AHA), is actively supporting hospital efforts to combat this form of trafficking. Visit AHA’s Hospitals Against Violence webpage to view readily usable resources and tools.


January 18, 10 a.m. – Introduction to POLST workshop

Join physician orders for life-sustaining treatment paradigm (POLST) for their one-hour virtual workshops equipping healthcare professionals with knowledge and resources to begin using POLST in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST, and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. Register here.

AzCHER Radiation Surge Annex Training and Tabletop Exercise

AzHHA’s Arizona Coalition for Healthcare Emergency Response (AzCHER) team will conduct a Radiological Surge Response Training and an HSEEP-compliant tabletop exercise to train and test key elements within the Radiation Surge Annex. Completion of either format will give you a better overall understanding of the response to an incident involving radiological materials, the Radiation Surge Annex and how to implement it into your agency’s emergency response plans. Participants may choose to join either our virtual or in-person option.

Feb. 23 – register for the in-person session │ March 2 – register for the virtual session

March 23 - AzCHER Annual Conference

Save the date for our 3rd Annual Conference at the Arizona Broadway Theatre. This year's theme will focus on Safety, Security and Situational Awareness. Registration will be available on the AzCHER website soon.


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