Assigned to HHS & APPROP AS PASSED BY COMMITTEE
ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
AMENDED
FACT SHEET FOR H.B. 2753
graduate medical education; residency programs
Purpose
Requires the Arizona Area Health Education System (Arizona AHEC), by May 1, 2024, to
establish a primary care residency program for outlined health care facilities. Appropriates
$5,000,000 from the state General Fund (state GF) in FY 2024 to the Arizona AHEC and
$5,000,000 from the state GF in FYs 2024, 2025 and 2026 to the Arizona Health Care Cost
Containment System Administration (AHCCCS).
Background
Established within the University of Arizona College of Medicine by the Arizona Board of
Regents, the Arizona AHEC consists of six area health education centers, five of which represent
a geographic area with identified populations that lack services by health care professions and one
that represents the Indian health care delivery system. Each health education center conducts
physician and other health professional education programs, including: 1) physician and other
health professional education programs, including a undergraduate clinical training program,
graduate program and postgraduate continuing education; 2) programs to recruit and retain
minority students in health professions; and 3) continuing education programs for health
professionals (A.R.S. § 15-1643).
AHCCCS must establish, contingent on approval by the U.S. Centers for Medicare and
Medicaid Services (CMS), a separate graduate medical education program (GME program) to
reimburse qualifying community health centers and rural health clinics that have an approved
primary care GME program. A qualifying community health center is a community-based primary
care facility that provides medical care in or to medically underserved areas or populations through
the employment of specified health professionals. AHCCCS must distribute monies appropriated
for GME programs to approved health entities for primary care GME program costs. Each GME
program that receives appropriated monies must identify and report to AHCCCS the number of
new residency positions created with the appropriated monies, including positions in rural areas
(A.R.S. § 36-2907.06).
A GME program prepares a physician for the independent practice of medicine by
providing didactic and clinical education in a medical discipline to a medical student who has
completed a recognized undergraduate medical education program (A.R.S. § 36-2901).
H.B. 2753 appropriates $5,000,000 from the state GF in FY 2024 to the Arizona AHEC
and $5,000,000 from the state GF in FYs 2024, 2025 and 2026 to AHCCCS.
FACT SHEET – Amended
H.B. 2753
Page 2
Provisions
1. Requires the Arizona AHEC, by May 1, 2024, to establish a program for qualifying community
health centers, rural health clinics and tribal health facilities that:
a) supports and expands the number of primary care residency positions;
b) provides support and technical assistance for starting or expanding primary care residency
programs in rural and health professional shortage areas; and
c) facilitates information and resource sharing and provides training and technical assistance,
including preceptor training and development, continuing education, medical library
access and other functions, to support the success of qualifying community health center,
rural health clinic and tribal health facility primary care residency programs.
2. Appropriates $5,000,000 from the state GF in FY 2024 to the Arizona AHEC to establish the
primary care residency program.
3. Allows the Arizona AHEC to use up to $500,000 of the appropriation to support a collaborative
of qualifying community health centers', rural health clinics' and tribal health facilities primary
care residency programs.
4. Expands the AHCCCS-established GME program to provide reimbursements for qualifying
health care services to advanced practice registered nurse (APRN) residency and fellowship
programs.
5. Appropriates $5,000,000 from the state GF in FYs 2024, 2025 and 2026 to AHCCCS for the
direct and indirect costs of primary care GME or APRN residency or fellowship programs at
qualifying community health centers, rural health clinics and tribal health facilities.
6. Requires AHCCCS, if AHCCCS has not received GME program approval from CMS by June
1, 2024, to distribute the GME program monies for that fiscal year to the qualifying community
health centers, rural health clinics and tribal health facilities that have approved primary care
GME or APRN residency or fellowship programs.
7. Allows the distributed monies, if CMS approval is received after June 1, 2024, to qualify as
the required match for the subsequent fiscal year.
8. Exempts the appropriations from lapsing.
9. Defines primary care and tribal health facility.
10. Makes conforming changes.
11. Becomes effective on the general effective date.
Amendments Adopted by the Health and Human Services Committee
• Adds, to the authorized uses of the $5,000,000 AHCCCS appropriation, the direct and indirect
costs of APRN residency or fellowship programs.
FACT SHEET – Amended
H.B. 2753
Page 3
Amendments Adopted by the Appropriations Committee
1. Expands the AHCCCS-established GME program to provide reimbursements for qualifying
health care services to APRN residency and fellowship programs.
2. Adds, to the authorized uses of the $5,000,000 AHCCCS appropriation, the direct and indirect
costs of APRN residency or fellowship programs.
3. Requires AHCCCS, if AHCCCS has not received GME program approval from CMS by June
1, 2024, to distribute the GME program monies for that fiscal year to qualifying health care
facilities that have approved primary care GME or APRN residency or fellowship programs.
4. Allows the distributed monies, if CMS approval is received after June 1, 2024, to qualify as
the required match for the subsequent fiscal year.
5. Makes technical and conforming changes.
House Action Senate Action
ED 2/14/23 DPA 8-0-1-1 HHS 3/21/23 DPA 7-0-0
3
rd
Read 2/28/23 31-28-1 APPROP 3/28/23 DPA 6-2-2
Prepared by Senate Research
March 29, 2023
MG/MC/slp