Department of Health and Human Services
DEPARTMENTAL APPEALS BOARD
Appellate Division
SUBJECT: Arizona Health Care Cost Containment System
Docket No. A-96-118
Decision No. 1583
DATE: June 24, 1996
DECISION
The Arizona Health Care Cost Containment System (AHCCCS)
of the Arizona Department of Human Services appealed a
decision by the Health Care Financing Administration
(HCFA) disallowing $13,065,209 in federal funds claimed
under title XIX of the Social Security Act (Medicaid).
The disallowance involves (1) expenditures for emergency
services to undocumented aliens claimed at a rate in
excess of the applicable Federal Medical Assistance
Percentage (FMAP), and (2) expenditures for nonemergency
services to undocumented aliens. The disallowance covers
claims for the period April 1, 1995 through September 30,
1995.
The issues presented by this case were previously raised
and addressed in Arizona Health Care Cost Containment
System, DAB No. 1569 (1996). In DAB No. 1569, the Board
concluded that (1) AHCCCS' costs for emergency medical
services for undocumented aliens in excess of the FMAP
are not allowable Medicaid expenditures; and (2) AHCCCS'
costs for nonemergency services, including prenatal
services, for undocumented aliens are not allowable
Medicaid expenditures.
Although AHCCCS disagreed with the Board's analysis in
DAB No. 1569, AHCCCS agreed that the Board should issue a
summary decision in this case since it presented no new
issues. HCFA also agreed to this course of action. We therefore sustain the
disallowance of $13,065,209
based on the reasoning and analysis in DAB No. 1569,
which we incorporate here in full.
__________________________
Donald F. Garrett
__________________________
Norval D. (John) Settle
__________________________
Judith A. Ballard
Presiding Board Member