Before October 1, 2018, Children’s Rehabilitative Services (CRS) provided medical treatment to AHCCCS members who have CRS-qualifying conditions. See Arizona Administrative Code A.A.C. R9-22-1303 Qualifying Medical Conditions for a list of CRS-qualifying conditions. Although CRS members got the same AHCCCS covered medical and behavioral health services as non-CRS members, there was no choice of health plan once a member was determined to be eligible for CRS. There was only one health plan available statewide.
As of Oct. 1, 2018:
AHCCCS Members with a CRS Designation Who Are NOT Enrolled in DES/DDD or Comprehensive Medical and Dental Program (CMDP) for Foster Children
Members who are determined to be eligible for CRS and are not enrolled in DES/DDD or CMDP will have choice of an AHCCCS Complete Care (ACC) plan. The ACC plan will include:
American Indian and Alaska Native members with a CRS-qualifying condition will have a choice of ACC Plan or the American Indian Health Program for all services. American Indian and Alaska Native members, on- or off-reservation, may choose to get services from:
AHCCCS Members with a CRS Designation Who Are Determined to Have a Serious Mental Illness (SMI)
Any member with a CRS designation who:
DCS CHP Members who are in Foster Care
Children in foster care who have CRS conditions will receive all physical health services, including services for their CRS condition, from the Department of Child Safety Comprehensive Health Plan (DCS CHP). Like all children in foster care, they will receive behavioral health services from the RBHA in their area.
As of Oct. 1, 2019:
Members Who Are Enrolled with DES/DDD
Members with developmental disabilities enrolled in DES/DDD with a CRS designation will use their assigned DDD health plan for:
What will be different for CRS referrals?
The CRS application and referral process will remain essentially the same. A member will not be enrolled in the CRS program unless AHCCCS eligibility is established. Members under the age of twenty-one (21) will continue to be referred to the AHCCCS Division of Member Services for a CRS designation as described below. ACC or DES/DDD health plans will be notified when a member has been determined to have a CRS condition.
Once approved for the CRS program, the member’s ACC, DDD plan, RBHA or CMDP will be notified of the CRS designation and should ensure first provider visit is within 30 days of the CRS designation. The member’s plan will manage care for the CRS condition(s), as well as, physical and behavioral health services for members. Members with a CRS Designation can get care in the community, and/or in multi-specialty interdisciplinary clinics (MSICs).
To refer a member for a CRS designation, fill out and mail or fax an application to the AHCCCS CRS Unit, with medical documentation that supports the applicant has a CRS-qualifying condition.
The application MUST be submitted with supporting medical documentation.
