Fiscal Note
BILL # HB 2230 TITLE: AHCCCS; outpatient services
SPONSOR: Longdon STATUS: As Introduced
PREPARED BY: Maggie Rocker
Description
The bill would add outpatient speech therapy as an AHCCCS benefit for adults ages 21+. AHCCCS currently covers
medically necessary inpatient speech therapy ordered by a physician. Outpatient speech therapy as a benefit is only
available for KidsCare and Arizona Long Term Care System (ALTCS) members as well as children under age 21 receiving
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services.
Estimated Impact
We estimate the full-year cost of providing outpatient speech therapy for acute care adults within AHCCCS would be
$179,400 General Fund ($854,100 Total Funds). Our estimates are based on a 2023 actuarial analysis from AHCCCS that
we have adjusted to account for estimated changes in population, inflation, and federal match rate since that time.
AHCCCS has not yet responded with an updated estimate.
Analysis
Speech therapy entails treatment for problems with language, speaking, or swallowing, including such services as lip
reading, non-oral language training, and articulation training. Currently all populations within AHCCCS are eligible to
receive medically necessary inpatient speech therapy ordered by a physician. Outpatient speech therapy, however, is only
offered as a benefit for KidsCare members, ALTCS members, and children receiving EPSDT services.
Based on ALTCS member utilization of outpatient speech therapy, AHCCCS's FY 2023 estimate assumed 15 percent of
acute care adults currently receiving inpatient speech therapy services (1,084 members) would subsequently receive
outpatient speech therapy. This number of projected acute care members multiplied by the average annual cost of ALTCS
members receiving outpatient services resulted in an annual cost of $139,500 General Fund ($746,200 Total Funds).
Adjusting for inflation, changes to the federal match rate, and population growth, we estimate the full-year cost of the
proposal would increase General Fund spending by $179,400 ($854,100 Total Funds).
Local Government Impact
None
1/22/24