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Committee advances a package of ACCESS and Medicaid integrity bills including eligibility checks and prior-authorization changes

Arizona State Senate Committee on Health and Human Services · January 28, 2026

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Summary

A set of bills to tighten Medicaid program integrity and ACCESS operations—data-matching and enrollment verification, dual-enrollment checks and limits on prior authorization for American Indian Health Plan members—received due-pass recommendations after agency witnesses outlined costs and operational impacts.

The Health & Human Services Committee advanced several bills intended to strengthen ACCESS program integrity and ease reported problems for certain provider groups.

SB 12-36 directs ACCESS to perform enhanced enrollment verification and data matching for member earnings, employment status and state residency and to seek federal waivers narrowing mandatory hospital presumptive eligibility; proponents said the changes respond to federal HR1 requirements and high error-rate exposure. Nicholas Kleinworth of the Paragon Health Institute said prior federal data show billions in improper payments and urged routine checks and documentation.

SB 11-71 would require ACCESS to run monthly reviews to ensure individuals are not enrolled both on the federally facilitated exchange and ACCESS; ACCESS staff said system changes and postage would be required for notifications but indicated willingness to work with the Legislature. SB 11-22, amended in committee, restricts ACCESS from requiring prior authorization for American Indian Health Plan behavioral-health services except when a corrective-action plan is in place; ACCESS offered that the amendment clarifies procedures and that it already uses prior-authorization and prepayment-review on specific codes.

Agency and policy witnesses emphasized the tradeoff between upfront implementation costs and longer-term savings and federal compliance. The committee adopted amendments where proposed, recorded due-pass recommendations on the bills and asked agencies to provide data and fiscal estimates off the record.