PHOENIX – The Arizona Health Care Cost Containment System is accepting public comments on its annual fee schedule rate updates, including a proposal to establish set rate codes for Applied Behavior Analysis (ABA) services that currently pay a percentage of the billed amount.
Changing the payment methodology from the current “by report” method to a set rate minimizes the possibility of fraudulent Medicaid claims billing against these codes and further strengthens the agency’s ability to eliminate fraudulent providers from its system. On Oct. 1, 2022, and May 1, 2023, AHCCCS made similar changes to other “by report” rate codes.
The Arizona Health Care Cost Containment System (AHCCCS) announces the qualified providers who have been selected to receive Differential Adjusted Payments (DAP) in Contract Year 2024.
The list of qualifying providers is posted on the Differential Adjusted Payment (DAP) web page.
The qualifying providers are listed by provider type and DAP, and are identified by name and NPI. The posted DAP rates will be effective for dates of service beginning October 1, 2023, through September 30, 2024.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) released its fourth monthly Medicaid renewal data dashboard detailing progress since the regular renewal process began on April 1, 2023.
Of the renewals initiated in August, more than 80% of members maintained their Medicaid coverage and 73% of those renewals were automatically determined to be eligible. The automatic process, known as ex parte, refers to an individual being determined eligible without the need for the member to provide additional information or proof. AHCCCS determines ex parte on the individual, not household, level, in compliance with CMS regulations.
More than 95,000 members who have been disenrolled since April for not responding to AHCCCS have taken advantage of the 90-day window to finish their renewal, with 48% of them meeting eligibility criteria and being reinstated.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) recently launched AHCCCS Connect, a new feature that sends personalized program reminders and updates to Medicaid applicants and members to guide them through every step of their Medicaid lifecycle, from initial application through annual renewal.
AHCCCS Connect sends SMS texts, automated voice calls, and/or emails to members who provide valid phone numbers and/or email addresses.
To receive these communications, AHCCCS members need to provide a phone number capable of receiving text messages, and/or an email address in their Health-e-Arizona Plus (HEAplus) account at www.healthearizonaplus.gov. New applicants will be automatically added to AHCCCS Connect when they provide an email address and/or cell phone number. Members are able to opt out of AHCCCS Connect at any time, and may rejoin at any time.
Join AHCCCS for community meetings designed to help members, families, and stakeholders learn about programs and initiatives, and to solicit feedback. All of the listed events are posted on the AHCCCS calendar and the Community Presentations web page.
TOPIC: Parents as Paid Caregivers 1115 Waiver Amendment
WHEN: Wednesday, September 6, 1:00 p.m.—2:00 p.m.
WHERE: Online on Zoom.
TOPIC: Overview and Upcoming Initiatives of the AHCCCS 1115 Demonstration Waiver
WHEN: Monday, September 18, 11:00 a.m.—11:30 a.m.
WHERE: Online on Zoom.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) has incorporated community feedback into its request for federal approval to extend Medicaid reimbursement to parents who provide caregiver services to their minor children with disabilities.
Based on public comments and feedback from parents, AHCCCS has added habilitation services to its 1115 Demonstration Waiver request, which it will submit to the Centers for Medicare and Medicaid Services in September. All proposal requests are subject to federal approval.
Prior to the federal submission, AHCCCS will host a public forum to inform stakeholders of the final waiver request on September 6, 2023 from 1:00 - 2:00 p.m. See the forum flier and register in advance using the link on the Parents as Paid Caregivers web page.
In July and August, AHCCCS held two public forums to solicit feedback from the community on this proposal and also gathered feedback via mail, email and other public meetings. The agency gathered more than 2,100 pieces of stakeholder feedback from over 1,700 individuals. The agency used this feedback to make significant changes to Parents as Paid Caregivers amendment proposal.
PHOENIX – AHCCCS updated the Provider Payment Suspension Fact Sheet on Aug. 23, 2023 to provide new information and resources about its efforts to stop fraudulent behavioral health billing and to protect members in tribal communities who’ve been targeted.
The Provider Payment Suspensions Fact Sheet includes additional provider enrollment and claims payment system changes made since June 14, 2023, a flow chart of the Credible Allegation of Fraud payment suspension process, and a flier about the 4 Steps to Review Provider Credibility.
Additional system-wide improvements to the Medicaid claims payment system include:
PHOENIX – The Maricopa County Community College District (MCCCD) will receive federal funding from the American Rescue Plan, administered by the Arizona Health Care Cost Containment System (AHCCCS), to address behavioral health workforce shortages.
House Bill 2691, signed during this year’s legislative session, created behavioral health workforce development programs at two community college systems, MCCCD and Northland Pioneer College. Collectively, approximately $9 million in American Rescue Plan funds will be distributed by Sept. 30, 2024, with another $4.5 million possible, depending on legislative action.
“Building more opportunities for students to earn behavioral health degrees and credentials will create a larger and better prepared pool of candidates for critical behavioral health jobs,” said Bill Kennard, AHCCCS Workforce Development Administrator. “Better prepared candidates enable providers to streamline the onboarding process for new workers, and ensure members receive care more quickly. Offering substantive, pre-service education and training for aspiring behavioral health workers is one step that will help Arizona meet its growing behavioral health care demands,” said Bill Kennard, AHCCCS workforce development administrator.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) and the Arizona Department of Economic Security (DES) have upgraded search features on Health-e-Arizona Plus, the enrollment and eligibility website (www.healthearizonaplus.gov) for Medicaid, SNAP, and Cash Assistance applicants and enrollees.
Now users can search for Community Assistors, organizations and individuals who help Arizonans enroll in benefit programs, by zip code or full or partial address. The new “Locate Me” feature returns geolocated results without the user having to input anything. The upgrade also allows users to search by radius and proximity to find assistors up to 50 miles away.
PHOENIX –The Arizona Health Care Cost Containment System (AHCCCS) has selected the Maricopa County Community College District (MCCCD) to lead the statewide collaborative partnership with Arizona’s ten community college districts that will focus on health care career development, education, and training of the state’s long-term care and behavioral health workforces.
AHCCCS was awarded $25.7 million in American Rescue Plan (ARP) Act Section 9817 funding to support the ARP Home and Community-Based Services (HCBS) Workforce Development Career Education and Training initiative. This initiative aims to increase the number of individuals who join the workforce to pursue health care careers while decreasing the number of workers who leave the field.
“More than 68,000 Arizonans receive long term care services through the Medicaid program because they require institutional levels of care,” said AHCCCS Workforce Development Administrator Bill Kennard. “However, most receive that level of care in their homes. Given that Home and Community Based Services are such a critical service, now is the time to build a workforce that supports our state’s needs.”
PHOENIX – The Arizona Healthcare Cost Containment System (AHCCCS) released $16.91 million in funding to providers of Home and Community Based Services (HCBS) throughout Arizona as part of the first round of the AHCCCS American Rescue Plan (ARP) Program Award. With these funds, HCBS providers can enhance the health, safety, and member experience of children, the elderly, people with disabilities, people living with a Serious Mental Illness (SMI) designation, and anyone else receiving HCBS in the state.
“We are so pleased to be able to use this one-time funding to strengthen the infrastructure and programs within the HCBS system,” said Carmen Heredia, AHCCCS director. “These projects will help 61 AHCCCS providers to make upgrades to their facilities and infrastructure to promote access, streamline service delivery, and augment their specific community’s services. Collectively, these projects will help AHCCCS members lead self-directed lives, engage in activities that promote wellbeing, and integrate into their communities through employment, transportation, social engagement.”
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) has released a Request for Proposal (RFP) to solicit participation by Managed Care Organizations (MCOs) to provide health care services to members of the Arizona Long Term Care System (ALTCS) who are elderly and/or who have a physical disability (EPD).
Join AHCCCS for community meetings designed to help members, families, and stakeholders learn about programs and initiatives, and to solicit feedback. All of these events are posted on the AHCCCS calendar and the Community Presentations web page.
PHOENIX – The Centers for Medicare and Medicaid Services (CMS) today released national reporting of the Medicaid renewal progress by state, based on reporting by each state for the months of March and April. Arizona was one of five states that began the renewal and disenrollment process as of April 1, 2023.
The CMS data is a snapshot of Arizona’s first month of renewals and does not reflect the current reality; the current Arizona Renewals dashboard is more illustrative of where the state stands today.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) launched a new feature that makes it easy for members to update their contact information. Sam, the chatbot on the Medicaid eligibility website www.healthearizonaplus.gov (HEAplus), can now process address changes directly in chat, in English and Spanish, with no need for the member to log into their HEAplus account.
Since launching at the end of June, more than 2,000 AHCCCS members have successfully updated their contact information in the chatbot in less than 3 minutes, on average.
Because the annual Medicaid renewal process began April 1, it is critical that enrolled AHCCCS members ensure their contact information is correct. As each member’s renewal is processed, AHCCCS may request additional information to verify eligibility.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) released its monthly Medicaid renewal data dashboard detailing progress since the regular renewal process began on April 1, 2023.
In the month of June, 67% of the renewals initiated were automatically determined to be eligible to maintain AHCCCS coverage. The automatic, also called exparte, process requires no response from the member and no action from a State employee. Approximately 25% of all individuals who have been disenrolled for not responding to AHCCCS have taken advantage of the 90-day window to finish their renewal.
To date, 41% of the 1,109,967 initiated renewals have maintained coverage, 18% have been discontinued, and 41% are in progress.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) became aware of a breach of personal information on May 11, 2023 affecting 2,632 individuals in Arizona who are enrolled Medicaid members.
Upon becoming aware of the breach, AHCCCS conducted an extensive internal investigation and determined that, due to a systems error, some household accounts in Health-e-Arizona Plus (HEAPlus, the AHCCCS eligibility system) were viewable to individuals not included in their household. The viewable details included first and last name, address, and the last 4 digits of social security numbers.
At the point of discovery, AHCCCS disabled the HEAPlus system toolbar that allowed members to view this information. Additional internal procedures have been implemented to ensure that this type of error cannot occur again. On July 3, 2023, AHCCCS will begin to notify, in writing, those members whose personal information was compromised.
The Arizona Health Care Cost Containment System (AHCCCS) will no longer accept requests for enrollment into the American Indian Health Program (AIHP) over the phone. This is a change to the enrollment procedures for individuals selecting AIHP as their assigned Medicaid health plan, and is an additional measure to prevent fraudulent enrollment.
The American Indian Health Program Change Request Form on the American Indian Health Program web page now reflects this change, and all new enrollment requests must be submitted in writing to AHCCCS by fax or email by an Indian Health Service (IHS), Tribally owned/and or operated 638 facility, or Urban Indian Health Organization on behalf of a member.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) announces two new tools to help enrolled Medicaid members complete their annual Medicaid renewal: live chat and automated phone calls to any individual whose renewal mail is returned.
The new live chat feature on www.healthearizonaplus.gov, the Medicaid eligibility website, is available during business hours to help enrolled members who have questions about their annual Medicaid renewal process. After hours, the chatbot SAM can answer more than 40 common questions about the renewal process.
“Live chat and automated phone calls are just a few tools AHCCCS is using to help members complete their renewal when it's their turn to do so,” Kristen Challacombe, AHCCCS deputy director of business operations, said. “We don’t want any eligible member to lose coverage. Each member will receive multiple touch points to encourage them to complete their Medicaid renewal, including a renewal notification one month prior to their renewal month and phone calls, texts, and/or email reminders, as well as an alert if their renewal is not completed by the response deadline.”
Annual Medicaid renewals began April 1 and, through March 2024, AHCCCS will determine eligibility for all 2.5 million members.
PHOENIX – The Arizona Health Care Cost Containment System (AHCCCS) has opened a public comment period through August 21, 2023 to solicit input on the request for federal approval to extend Medicaid reimbursement to parents who provide caregiver services to their minor children.
AHCCCS will hold two virtual public forums to gather feedback on this proposal at 2:00 p.m., July 18, 2023 and 1:00 p.m., August 2, 2023. See the forum flier and register in advance for either forum using the link on the Parents as Paid Caregivers web page.
Public comments may also be submitted by email to email@example.com or by mail to the address on the Parents as Paid Caregivers web page.
PHOENIX – The Arizona Health Care Cost Containment Services (AHCCCS) today received the Healthy Arizona Worksite Platinum Award for the fifth consecutive year for demonstrating efforts to positively affect the health of its employees. The Platinum level award is given to organizations that properly identify health challenges among their employees and actively work to overcome them.
“We are honored to receive this award for a fifth time, which is a testament to the value AHCCCS places on employee work/life balance and well-being, ” said Carmen Heredia, AHCCCS director. “With a majority remote workforce, maintaining that focus in a virtual environment is even more challenging. We have shifted the focus from in-office events to supporting a healthy workplace, whether in office or remote, for all employees.”
In response to the discovery of significant fraudulent Medicaid behavioral health billing in Arizona, AHCCCS has made numerous system changes to stop deceptive providers who bill for services that are or were not provided, not appropriate, or not necessary. See the Provider Payment Suspensions Fact Sheet updated 6/14/2023.
Some of the holistic, system-wide improvements to the Medicaid payment system include:
AHCCCS announces five leadership positions that have been filled in the agency, rounding out the executive management team and completing the new structure that combines the Division of Fee for Service Management (DFSM), the Division of Community Advocacy and Intergovernmental Relations (DCAIR), Communications, and Legislative Affairs under a new Deputy Director of Community Engagement and Regulatory Affairs.
The Arizona Perinatal Psychiatry Access Line (APAL), scheduled to open in June, will offer health care providers free consultations on how to treat pregnant and postpartum persons.
Funded through a $1.6 million grant from AHCCCS, partners at the University of Arizona College of Medicine – Tucson and Banner - University Medicine will launch a new service in June for health care providers who care for pregnant and postpartum persons experiencing mental health and substance use conditions. The project comes amid rising rates of mental illnesses and maternal mortality, and a shortage of psychiatric providers trained to care for pregnant and postpartum individuals.
AHCCCS announces two new Renewals Awareness Messaging toolkits and supporting materials to assist health plans, providers, community partners, and tribal communities to build awareness of the regular renewals process that began April 1.
There are two versions of the Renewals Awareness Toolkits – one for Managed Care Organizations (MCOs) and providers, and another for tribal communities and providers. The new toolkits are available on the Renewals web page.
AHCCCS is continuing to work with community partners, advocates, tribal communities, and members to make sure eligible members remain covered, and that those who are no longer eligible are referred to sources for other health care coverage options.
AHCCCS announces a change in the planned start date of its federally-approved Housing and Health Opportunities (H2O) waiver demonstration project in order to complete operational and system integration planning. The new implementation date is October 1, 2024.
The Housing and Health Opportunities waiver demonstration project is an innovative approach to address health-related social needs for AHCCCS members with a Serious Mental Illness who are leaving a correctional setting or have additional chronic health conditions. Prior to implementation, AHCCCS must receive approval from the Centers for Medicare and Medicaid Services (CMS) on two deliverables that will describe the operational details of the program. AHCCCS submitted the H2O Protocol, the first of these two deliverables in April. Subsequently, CMS and AHCCCS agreed that additional time will be needed to complete the implementation planning.
Effective May 18, 2023, AHCCCS has made system updates to the AHCCCS Online Claims Submission system that restrict a provider’s ability to bill on behalf of other providers. This change increases system integrity and reduces the risk of fraudulent billing.
Providers may only submit claims for IDs associated with affiliated providers. Approved affiliated providers will display in a drop-down list. If an affiliated provider is not listed, the billing provider must create a new AHCCCS Online account for the provider they wish to bill for. Only providers registered with AHCCCS can create an AHCCCS Online account.
As you check off the list of your child’s back-to-school items, AHCCCS encourages parents to schedule a well-care visit for health screenings and routine vaccines. AHCCCS or KidsCare members, ages 3-19, and who complete their first well-care visit of 2023 between June 5 and Sept. 5 are eligible to receive a $25 gift card from their health plan.
“Well-care visits are a vital tool to screen for health conditions and preventable diseases,” said Dr. Sara Salek, chief medical officer at AHCCCS. “We want to help children get a healthy start this school year.”
AHCCCS members who have recently lost AHCCCS coverage and are now enrolled with another health insurance company may be able to continue seeing a previous health care provider to continue a course of treatment.
Arizona law allows a new member in a health insurance plan with a life-threatening illness or in the last trimester of pregnancy to continue an “active course of treatment” with their previous health care provider when certain requirements are met. This continuity of care lasts only for a limited time. The new member must send a written request to the new health plan in order to ask to continue care with a previous provider.
The Arizona Health Care Cost Containment System (AHCCCS) announces a dedicated hotline at 2-1-1 (press 7) for any American Indian Health Program or other AHCCCS member who may need help due to the closure of a sober living home or residential facility. This hotline will be available 24 hours a day, 7 days a week. Navigators at the hotline are equipped to help callers with related transportation and immediate housing needs if they’ve been displaced, and to help them find other health care services.
“AHCCCS is dedicated to putting our members first and ensuring they have access to the health care services they need,” said Carmen Heredia, AHCCCS director. “This new member hotline is a real-time mechanism for members who are affected by a provider closure to alert trained responders that they need help.”
The 2-1-1 (press 7) hotline is hosted by Arizona 211, the community information referral service program administered by Solari, Inc., the state’s 988 and Arizona crisis response vendor. Solari, Inc. is staffed to assist individual AHCCCS members and any large groups of members who might be affected. Mobile crisis teams are ready to deploy whenever members need hands-on, immediate behavioral health services, transportation, or care coordination related to a provider closure.
Effective May 29, 2023, three types of behavioral health providers are required to register as a high risk provider type and meet additional requirements.
Affected provider types include:
Today, Governor Katie Hobbs and Attorney General Kris Mayes joined the Arizona Health Care Cost Containment System (AHCCCS) Office of Inspector General (OIG) to announce payment suspensions against more than 100 unique, registered behavioral health providers of Medicaid services based on credible allegations of fraudulent billing activities, in conjunction with the Arizona Attorney General’s Healthcare Fraud and Abuse Section, the Federal Bureau of Investigation, the US Department of Health and Human Services, the US Attorney’s Office, and the Internal Revenue Service.
Provider payment suspensions, known as Credible Allegations of Fraud (CAF) suspensions, are the first step of required action when Medicaid payment fraud is identified, and the beginning of multi-agency investigations.
“The State of Arizona is taking swift action to stop a humanitarian crisis, root out waste, fraud and abuse, and crack down on bad actors exploiting Tribal communities,” said Governor Katie Hobbs. “I’m proud of our law enforcement officials and AHCCCS for taking action to hold fraudulent billers accountable and protect some of our state’s most vulnerable communities."
“I am proud of the work done by the law enforcement officials, and in particular those at Arizona Attorney General’s Office in investigating fraud and abuse of taxpayer dollars,” said Attorney General Kris Mayes. “Fraudulent Medicaid billing harms taxpayers and puts vulnerable individuals at risk of not receiving needed health care services. Together, the Attorney General’s Healthcare Fraud and Abuse Section and AHCCCS will continue to disrupt organized fraudsters, apprehend them, and prosecute them to the full extent allowed by law.”
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid program, launched a new tool to make it easier for law enforcement agencies to request data that may help them find missing persons. This is one of several strategies AHCCCS is implementing to find missing persons, especially American Indian members enrolled in the American Indian Health Program from AHCCCS.
“AHCCCS is improving the tools we have to help law enforcement partners find missing American Indian Health Program members and other Medicaid enrollees,” said Carmen Heredia, AHCCCS director. “As we have learned more about this issue, it became clear that we could expedite and streamline the data sharing process for law enforcement agencies.”
Effective May 1, 2023, AHCCCS has set a rate for fee-for-service providers who provide behavioral health services and bill AHCCCS for intensive outpatient program treatment. This change established a set rate of $157.86 for one unit of billable service, a change from the prior rate methodology which paid 58.66% of the billed amount.
AHCCCS established this fixed rate for billing code H0015 after a thorough data analysis of rates paid for these services by other Medicaid programs and AHCCCS managed care organizations, as well as the current AHCCCS reimbursement for comparable services. While the new rate may be lower than what was billed by some providers under the prior methodology, it is approximately $25 higher than industry average.
To continue the work of the Arizona Abuse and Neglect Prevention Task Force Report, AHCCCS, the Arizona Department of Economic Security (ADES), and the Sonoran University Center for Excellence in Developmental Disabilities (UCEDD) are surveying providers of long-term-care services, including Home and Community Based Services, residential, institutional, day care, employment, and direct care workers.
The survey is open through May 31, 2023, and will take about 10 minutes to complete. Responses are confidential.
AHCCCS has developed new policies and made system changes to implement high-risk screening for new and revalidating Non-Emergency Medical Transportation (NEMT) provider type 28 (PT-28) applicants beginning May 1, 2023. This new policy will allow any NEMT PT-28 to apply directly for provider registration in the AHCCCS Provider Enrollment Portal (APEP), effective May 1, 2023.
Meet SAM, the new virtual assistant designed to help Medicaid members get fast answers to common questions.
The Arizona Health Care Cost Containment System (AHCCCS) recently launched SAM, a virtual assistant, on the www.healthearizonaplus.gov website. SAM is available 24 hours a day to answer more than 30 common questions related to AHCCCS renewals.
“With the return to the regular Medicaid renewal process starting this month, AHCCCS is expecting increased traffic to our call centers and websites as the state redetermines eligibility for all 2.5 million AHCCCS members in the coming year,” said Kristen Challacombe, AHCCCS deputy director of business operations. “This chatbot is just one example of how we are implementing advanced technologies to improve the customer experience and reach members in new ways with important renewal information.”
In an effort to improve maternal and child health outcomes and increase access to life-saving health care services, AHCCCS has extended postpartum coverage for a full 12 months, effective April 1, 2023.
“Medicaid covers more than half the births in Arizona. Extending postpartum coverage will help us address healthcare disparities for our postpartum population, which includes a disproportionate number of our American Indian or Alaskan Natives at increased risk of severe morbidity,” Governor Katie Hobbs said.
“The 12-month expansion of postpartum coverage is especially timely given the return to regular renewals which began this month,” said Dr. Sara Salek, the AHCCCS chief medical officer. “This policy change means that members who previously would have only had 60 days of postpartum coverage are now eligible for health care coverage for a full year. This is a critical period for Arizonans recovering from childbirth. It also extends our chances to address complications that contribute to postpartum morbidity and mortality, ensure ongoing mental health, and manage infant care.”
Arizona has seen an alarming rise of fentanyl and counterfeit pill deaths; in 2021, 96% of opioid deaths involved prescription or synthetic drugs. Naloxone, the opioid overdose reversal drug, has been proven to counteract the effects of these drugs and save lives.
AHCCCS used problem-solving techniques to identify an immediate need to increase naloxone distribution and build public awareness about its efficacy.
The Substance Abuse Coalition Leaders of Arizona, composed of substance abuse prevention coalitions statewide, created a toolkit and a statewide media campaign to increase public awareness of the availability of naloxone. The campaign coupled forums, presentations, training, and prevention programming events to leverage naloxone distribution in Arizona communities.
AHCCCS funded two major naloxone distribution projects through Arizona Department of Health Services (ADHS) and Sonoran Prevention Works (SPW). ADHS mainly focused on distribution through law enforcement agencies, county health departments, emergency departments and community-based organizations. SPW focused on distribution to active users.
The earliest years of life are the optimal time to build supportive and healthy child/caregiver relationships. Positive experiences help young children build brain architecture, and they help to set skills necessary for healthy development. Establishing strong, healthy relationships from the start can lead to optimal development and lessen chances for engagement in unhealthy behaviors as children grow to adulthood and beyond.
Anyone who works with infants, toddlers and children ages 0 to 5 can use the Early Childhood Service Intensity Instrument© (ECSII), a standardized, biopsychosocial assessment tool to improve their ability to provide services.
AHCCCS offers training on how to use the ECSII. The training is available at no cost to health care providers and anyone who works in the behavioral health field with this population.
AHCCCS is investing funds from the American Rescue Plan (ARP) into a new $40 million award program to strengthen Home and Community Based Services (HCBS) in the State.
Starting on April 17, providers can apply for up to $500,000 for programmatic or infrastructure projects to improve the health, safety, and member experience of individuals who receive HCBS. All applications must be submitted by 5:00 p.m. on May 16, 2023.
In its initial stages of updating its 30-year-old mainframe database, AHCCCS has released a strategic roadmap outlining project recommendations and considerations to modernize its Medicaid Enterprise System (MES).
AHCCCS and Med-QUEST Division (MQD), Hawaii’s Medicaid program, share an MES system. Together, they commissioned NTT Data Services, a national leader in Medicaid technology development, to assess the need to replace legacy infrastructure.
The current MES, developed on outdated mainframe application technology, has limited self-service capabilities, inflexible core systems, and is aging beyond a workforce with the skills to support it. In its MES Modernization Roadmap document, NTT weighs several critical factors and presents recommendations for the system upgrade project.
The Arizona Department of Health Services (ADHS) and the Arizona Health Care Cost Containment System (AHCCCS) are partnering on a new public awareness campaign called “Hope Always Answers” that promotes the 988 Suicide and Crisis Lifeline.
People can reach the 988 suicide and crisis lifeline by dialing 988 from any phone, texting 988 from a mobile phone, chatting 988 or going to 988.az.gov. The crisis line is available 24 hours a day, seven days a week, to anyone experiencing suicide crisis, substance-related issues, social isolation, depression, relationship struggles, or any type of mental or behavioral health issues. Friends and family members can also use 988 on behalf of someone experiencing any type of mental or behavioral health crisis.
Sheila Sjolander, interim deputy director of Public Health Services at ADHS, said the new crisis line is a critical tool in helping to reduce the number of suicides in our state. In 2022, according to preliminary data from ADHS, 1,593 individuals in Arizona died by suicide, the highest number ever recorded in Arizona’s history.
Members, don’t wait for the mail to be delivered—sign up to receive texts or emails from AHCCCS. Get notification of news, alerts, and letters from AHCCCS as soon as they are sent.
All you need is a Health-e-Arizona Plus online account. If you don’t have one, create one today on Health-e-Arizona Plus at www.healthearizonaplus.gov.
In your www.healthearizonaplus.gov account you can:
AHCCCS received federal authority to reimburse Community Health Workers (CHWs) for services provided to Medicaid members. CHWs are an integral and essential part of the health care delivery system, often at the front lines of the intersection between communities and health care providers. CHWs often are also known by other names, such as Community Health Representatives, Patient Navigator, Promotores de Salud, Community Health Advisors, and Cultural Health Navigators, to name a few.
In 2018 the Arizona Legislature passed, and the Governor signed, House Bill 2324, which required the Arizona Department of Health Services (ADHS) to establish qualifications, a scope of practice, and core competencies for Certified Community Health Workers (CHWs). See the ADHS Community Health Workers web page.
In the first month of its planned process to terminate non-compliant providers, AHCCCS has identified 5,288 providers who have not taken the required action to maintain their registered status.
The process to revalidate registered providers began in November 2022 with letters mailed to the first group of providers. They were asked to revalidate in the AHCCCS Provider Enrollment Portal (APEP) within 90 days. Only 8% took the action requested to maintain their registration. The 5,288 who did not comply will be terminated in February.
Any provider who has not completed the revalidation process in APEP will receive written notification to submit an application. Providers who do not respond will receive written notification of pending termination and appeal rights.
As a result of the 30 recommendations from the Abuse and Neglect Prevention Task Force Report and the work accomplished thus far, AHCCCS, the Arizona Department of Economic Security, and the Sonoran University Center for Excellence in Developmental Disabilities (UCEDD) will conduct a provider survey in February.
This survey, like the first survey conducted in fall 2021, will ask for feedback from providers of long-term-care services, including Home and Community Based Services, residential, institutional, day care, employment, and direct care workers.
AHCCCS has posted a messaging toolkit and supporting materials for health plans, providers, and community organizations to use to amplify awareness about the return to regular Medicaid renewal processes which begin April 1, 2023.
Visit the www.azahcccs.gov/Renewals web page for frequently asked questions from members about the renewal process, and use the End of Continuous Enrollment Toolkit materials to educate communities about the upcoming renewal processes.
AHCCCS has awarded a contract to Solari, Inc. to maintain and improve the standardized processes used to determine eligibility for Arizonans who may have a Serious Mental Illness (SMI), and to standardize the Serious Emotional Disturbance (SED) determination process, in order to ensure that individuals with these designations are promptly identified and enrolled. Solari’s initial contract is from October 1, 2023 through September 30, 2026 with options to extend, but not to exceed a total contract period of five years. Solari, Inc. held the prior contract for SMI determinations.
AHCCCS reminds enrolled members and the public to report any suspicious activity where health care or residential services, and transportation to these services, are promised. Specifically, the agency is aware of two ongoing targeting activities:
There are many ways to report suspicious activity. AHCCCS works closely with the Arizona Department of Health Services (ADHS), the FBI, and local law enforcement to route tips to the correct agency. Use any of these resources to report. There is no “wrong way” to report suspicious activity.
The FBI is seeking information from the public about victims who may have been recruited to live in and receive services in group homes (Behavioral Health Residential Facilities) located in Phoenix, Arizona, between January 2020 to present.
See this news release and questionnaire from the FBI: Seeking Victims in the Phoenix Group Homes Targeting Native Americans Investigation
The Arizona Department of Health Services (ADHS) licenses sober living homes (see this Fact Sheet) and behavioral health residential facilities. If you suspect violations at a facility, report it online using the DHS Licensing Complaint Form.
To verify a provider’s license, and view cited deficiencies and corrective action enforcement, see www.azcarecheck.com.
If you are not sure whether your suspicion involves Medicaid fraud, submit it to AHCCCS and we will route it as needed.
Anyone can report provider or member fraud on the Report Fraud web page or by calling:
PHOENIX – On Dec. 23, 2022, Congress passed legislation which will end the Medicaid continuous enrollment requirement related to the COVID-19 pandemic on April 1, 2023. At that time, AHCCCS will be required to reverify the eligibility status of all members enrolled in AHCCCS and KidsCare (Arizona’s CHIP program).
AHCCCS will complete a full eligibility renewal for all 2.4 million enrolled members over the course of 12 months, following a careful plan to limit gaps in health care coverage for Arizonans. Members will be notified of their eligibility renewal prior to their month of renewal.
AHCCCS is aware of individuals targeting American Indians/Alaskan Natives who reside on tribal reservations by recruiting and transporting them to live in what they are calling sober living homes or behavioral health residential facilities in Phoenix. Some are not licensed health care providers who are not following through with promised services
We encourage AHCCCS members to be extremely cautious about getting into vehicles with individuals they do not know, and to advocate for your own health care services before accepting treatment. Ask questions and obtain as many details as possible, including the company name and address, name of individual, facility address and whether the facility is licensed, vehicle license plate number, and date and location of contact.
December 21, 2022
AHCCCS has extended the deadline for providers to begin reporting the individual practitioner who rendered services on professional and dental service claims until January 1, 2023. This requirement impacts all claims for AHCCCS providers registered as integrated clinics (Provider Type IC), behavioral health outpatient clinics (Provider Type 77) and clinics (Provider Type 05).
See Exhibit 10-1 of the AHCCCS Fee-For-Service Provider Billing Manual for billing instructions for proper claims submissions.
With Substance Abuse Block Grant funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), AHCCCS recently launched “Talk Heals,” a public awareness campaign aimed to reduce substance misuse among youth by encouraging them to talk to trusted people in their lives.
“Talk Heals” uses emojis and familiar scenarios in youth culture to reach youth with relevant messaging that they themselves would be likely to share with their peers.
PHOENIX — The Centers for Medicare and Medicaid Services (CMS) approved Arizona’s request for a five-year extension of its 1115 Waiver, the agreement with the federal government that authorizes the Arizona Health Care Cost Containment System (AHCCCS) to reform and modernize the State’s Medicaid program.
This 1115 Waiver approval continues the long-standing authorities and programs that have made Arizona’s Medicaid program innovative, effective, and efficient, including integrated managed care for AHCCCS populations through AHCCCS Complete Care (ACC); the Arizona Long Term Care System (ALTCS); the Comprehensive Health Plan (CHP) for children in foster care; and Regional Behavioral Health Agreements (RBHAs) which provide integrated care for individuals with a Serious Mental Illness (SMI).
In addition to renewing these historic programs, this 1115 Waiver includes approval for transformative projects intended to advance member health outcomes.
In a Request for Proposal (RFP) that opens Oct. 5, AHCCCS is seeking a vendor to provide Serious Mental Illness (SMI) eligibility determinations as well as Serious Emotional Disturbance (SED) eligibility determinations. The contract will begin October 1, 2023.
Several additions to Arizona’s Medicaid benefits were approved in the last legislative session and took effect on Oct. 1, 2022.
Diabetes Self-Management Training
AHCCCS will provide up to 10 program hours annually of diabetes outpatient self-management training services to members with new or existing diabetes diagnoses. The training must be prescribed by a primary care practitioner.
AHCCCS covers biomarker testing for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of a member’s disease or condition when the test is supported by medical and scientific evidence. New legislation adds coverage of four additional biomarker tests that the Centers for Medicare and Medicaid Services (CMS) considers useful for therapeutic decision-making.
AHCCCS will cover up to 20 medically necessary chiropractic visits for adults each year. Services must be ordered by a primary care provider and within the scope of chiropractic practice as defined by state law. Additional chiropractic services may be authorized in the same year if determined to be medically necessary.
In April 2022, AHCCCS reinstated provider enrollment requirements that had been suspended during the COVID-19 public health emergency. Beginning in October, AHCCCS will start a 10-month process of disenrolling providers who have not complied with multiple re-registration requests.
Any provider who has not completed the revalidation process in the AHCCCS Provider Enrollment Portal will receive written notification to submit an application. Providers who do not respond will receive written notification of pending disenrollment and appeal rights.
To avoid termination and/or loss of billing privileges, providers must respond and take action, following specific actions outlined in the letter, within the noted time frames. Failure to complete these actions result in disenrollment and claim denials.
AHCCCS wants your opinion! Starting today, Oct. 3, customers who call AHCCCS will be asked to participate in an optional, short survey about their experience.
With your feedback, AHCCCS will be able to gauge customer satisfaction with resolving a problem, identify potential opportunities for improvement, and set future goals.
At the end of a phone call, the survey will ask four questions, recorded in both English and Spanish, asking the caller to indicate a satisfaction level of 1 to 4, with 4 being the best customer experience.
September 22, 2022
Jami Snyder, director of AHCCCS, has announced her intention to leave her position at the end of 2022. Snyder has served as the agency’s director since 2019.
“I have been incredibly fortunate to have had the opportunity to serve in a leadership role for one of the most respected Medicaid programs in the country,” Snyder said. “Spearheading the work of a state agency that impacts the lives of almost 2.5 million Arizonans has been demanding, exciting, and immensely rewarding.”
Snyder was appointed by Governor Doug Ducey on Jan. 5, 2019 after having served as AHCCCS deputy director, and director of Texas’ Medicaid program prior to that.
“I’m deeply grateful to have had Jami Snyder’s talent, acumen, and compassion at the head of AHCCCS over the last four years," said Governor Ducey. "Under her leadership, AHCCCS navigated an unprecedented health care pandemic, expanded Arizona students’ access to behavioral health services, and moved 80 percent of the AHCCCS workforce to full-time remote work, saving taxpayers $1.2 million. She has navigated extremely complicated health care issues during her tenure, always with a focus on the best interest of the Arizonans she serves. The state thanks her for all she has done for its citizens and her dedicated leadership.”
September 20, 2022
AHCCCS Director Jami Snyder received the 2022 HIE Excellence Leadership Award from Contexture, Arizona’s health information exchange, for outstanding leadership in the health information technology area. The award, bestowed during the 15th Annual Arizona HIE Summit & Trade Show, recognizes Snyder for advancing technological solutions aimed at improving quality and patient experience while lowering costs.
“Thank you, Contexture, for recognizing the work AHCCCS is doing to find ways to innovate, improve health outcomes, and bend the health care cost curve,” Snyder said. “Together, we are realizing the impact we can have when we extend our understanding of integrated care to meet the needs of the whole person.”
September 13, 2022
Arizona honored by the Robert Wood Johnson Foundation & the National Academy for State Health Policy with 2022 Medicaid Innovation Award
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid program, received a 2022 Medicaid Innovation Award presented by the Robert Wood Johnson Foundation (RWJF) and the National Academy for State Health Policy (NASHP). The nonpartisan award recognizes states for demonstrating creativity, leadership, and progress in their Medicaid programs despite significant public health challenges in recent years.
AHCCCS received the award for its work on initiatives to address social determinants of health and their impact on whole person care.
Selected by a panel of expert advisers, Medicaid Innovation Award recipients are Medicaid agency leaders who implemented or enhanced initiatives that demonstrate innovative and unique approaches to improving the health and lives of Medicaid enrollees.
September 13, 2022
In 2022, Governor Doug Ducey signed legislation to extend health care benefits to 12 months for postpartum women enrolled in Medicaid. This week, the Arizona Health Care Cost Containment System (AHCCCS), the state’s Medicaid agency, submitted a request for federal approval to implement this extended coverage to all enrolled members who are or become pregnant.
“This year, Arizona passed a historic budget that will continue to prioritize the lives and livelihoods of our residents,” said Governor Doug Ducey. “I’m proud that our budget will ensure that low-income mothers have the health care services they need during pregnancy and in that critical first year of life.”
“Extending Medicaid postpartum benefits will provide increased access to services that can address pregnancy-related complications that contribute to maternal morbidity and mortality,” said Dr. Sara Salek, chief medical officer at AHCCCS.
August 31, 2022
The AHCCCS Office of Individual and Family Affairs (OIFA) and the Office of Human Rights (OHR) hold community meetings each month to help members, families, and stakeholders learn about programs and initiatives, and to solicit feedback. We ask you to share this information with your patients, clients, families, and stakeholders so they can better understand Arizona’s Medicaid services and how to find community resources and tools.
August 24, 2022
During National Suicide Prevention Awareness Month in September, AHCCCS is working with state agencies, organizations, and coalitions to educate citizens about the role that everyone plays in preventing suicides. Governor Doug Ducey proclaimed September 2022 Suicide Prevention Awareness Month in Arizona, citing that:
In coordination with the Arizona Department of Health Services (ADHS), suicide prevention is included in the 2021-2025 Arizona Health Improvement Plan.
August 11, 2022
If you or a loved one is enrolled with the Arizona Long Term Care System for Elderly and Physically Disabled (ALTCS-EPD) that serves individuals who are aging or have physical disabilities, or if you are an AHCCCS-registered provider serving this population, we want to hear about your experiences.
AHCCCS is working on new health plan contracts for the ALTCS-EPD program and needs your input on what is working well and where there are opportunities for improvement.
July 28, 2022
AHCCCS is accepting public comments on the proposed 2022 Arizona Olmstead Plan through Sept. 22, 2022.
Olmstead is a 1999 United States Supreme Court decision that provided a legal framework to integrate individuals with disabilities into the communities in which they live. The Olmstead Plan benefits individuals who may be at risk of institutionalization, including individuals with behavioral health needs and members of the Arizona Long Term Care System (ALTCS) program.
July 26, 2022
When the federal Public Health Emergency (PHE) ends, AHCCCS must reinstate many regular enrollment and operational procedures that have been suspended since March 2020. To inform stakeholders of the operational plan, AHCCCS has posted a Summary Public Health Emergency Operational Unwinding Plan.
Find the plan on the Preparing for the End of COVID-19: Return to Normal Renewals web page along with fliers, messaging toolkits, and other resources to help communities prepare for the end of the PHE.
July 11, 2022
As of November 1, 2022, providers contracted to deliver non-skilled in-home services (i.e., attendant care, personal care, homemaker, habilitation, respite) and in-home skilled nursing services ( i.e., home health) must be compliant with Electronic Visit Verification (EVV) in order to receive Medicaid reimbursement for services.
Over the past two years, AHCCCS, its vendor partner Sandata, its contracted managed care organizations (MCOs), and the Centers for Medicare and Medicaid Services (CMS) have been preparing to enforce EVV compliance by monitoring provider readiness milestones, conducting outreach, and providing technical assistance to the provider community.
June 21, 2022
The Arizona Health Care Cost Containment System (AHCCCS) and Tucson-based PAXIS Institute are pleased to announce a four-year partnership to expand the use of PAX Tools in the state of Arizona.
June 14, 2022
The Arizona Health Care Cost Containment System (AHCCCS) received Platinum level recognition for the fourth consecutive year from the statewide Healthy Arizona Worksites Program for demonstrating data-driven programming and leveraging cross-sector collaborations to improve the health, well-being and equity of employees and the community. The Platinum level award recognizes organizations for addressing health challenges impacting communities across the state.
June 9, 2022
AHCCCS is accepting public comment through July 5, 2022 regarding Home and Community Based Settings (HCBS) that meet the criteria for Heightened Scrutiny. Heightened Scrutiny is required by the Centers for Medicare and Medicaid Services (CMS) when a setting might share some characteristics of an institution (i.e. isolating people from the broader community), but there is an indication through an assessment that the setting can comply with the HCBS Rules by March 2023.
April 21, 2022
AHCCCS has awarded a new contract to two collaborative vendors who will provide housing and health care services in a new transitional housing facility for individuals experiencing homelessness and living with a Serious Mental Illness (SMI) designation.
Copa Health and Central Arizona Shelter Services (CASS) have been selected to provide services at a new transitional housing facility to be built in downtown Phoenix at the northeast corner of 24th Street and Van Buren Street. The facility will include transitional housing for up to 70 residents, as well as an on-site health care clinic open to the public. Initial capital funding for the project was approved by the Arizona State Legislature and supplemented with funds from the American Rescue Plan Act (ARPA).
March 30, 2022
As of June 1, 2022, AHCCCS providers must begin to report the individual practitioner who rendered services on professional and dental service claims. This requirement impacts all claims for AHCCCS providers registered as integrated clinics (Provider Type IC), behavioral health outpatient clinics (Provider Type 77) and clinics (Provider Type 05).
March 24, 2022
October 1, 2022 is the effective date of expanded AHCCCS Complete Care contracts with three managed care organizations, Mercy Care, Arizona Complete Health-Complete Care Plan, and Care1st, who will provide integrated health care services for members with a Serious Mental Illness designation.
Formerly called Regional Behavioral Health Authorities (RBHAs), these new contracts will be known as AHCCCS Complete Care Contractors with Regional Behavioral Health Agreements, or ACC-RBHAs. The current Geographic Service Areas (GSAs) will be aligned to match the ACC and ALTCS-EPD service areas. Gila County will move from the North GSA to the Central GSA, and Pinal County will move from the South GSA to the Central GSA; thus Central will expand from one county to three (Maricopa, Gila, and Pinal).
March 22, 2022
In March 2020, the federal government declared a national “public health emergency” (PHE). With it, AHCCCS was required to suspend disenrollments for most members (unless they moved out of state, aged out of KidsCare, voluntarily disenrolled, or died). Disenrollment suspensions will remain in place until the end of the federal PHE. While AHCCCS expects that the federal government will again extend the existing PHE past the current termination date of April 16, it is unknown for how long it may be extended. The federal government has indicated that it will provide states at least 60 days notice prior to the end of the PHE.
March 15, 2022
PHOENIX—Do you or a family member currently have health coverage through AHCCCS, Arizona’s Medicaid program or the Children’s Health Insurance Program (known as KidsCare)? If so, you may soon need to take steps to find out if your coverage can be continued.
January 25, 2022
AHCCCS is aware that an error occurred when AMPM Policy 310-X was posted to the public comment portal. A portion of the policy pertaining to speech therapy services for adult ALTCS members was accidentally omitted. AHCCCS takes full responsibility for the error. The policy has been revised and reposted, and public comments will be accepted for an additional two weeks, through February 8, to allow stakeholders to thoroughly review the proposed policy changes.
January 19, 2022
The Centers for Medicare and Medicaid Services (CMS) has granted approval of AHCCCS’ HCBS Spending Plan which allows the agency to begin implementing all of the activities in its spending plan and narrative, and qualify for a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for home and community-based services (HCBS).
The additional funding, made available through the American Rescue Plan Act of 2021 (ARPA) will be used to enhance the state’s HCBS and behavioral health programs. AHCCCS will receive the enhanced 10 percent FMAP through March 31, 2022 on qualifying home and community-based and behavioral health services. Implementation activities detailed in the spending plan will run through March 31, 2024.
January 21, 2022
The Sonoran Center for Excellence in Disabilities, in collaboration with AHCCCS, is surveying ALTCS members in long term care settings and their families. The survey asks questions about whether members feel safe and protected. Individual answers will not be shared.
January 3, 2022
All health care providers who refer AHCCCS members for an item or service, who order non-physician services for members, who prescribe medications to members, and who attend/certify medical necessity for services and/or who take primary responsibility for members’ medical care must be registered as AHCCCS providers. AHCCCS calls this initiative, and these providers, "ROPA.”
Federal ROPA requirements stipulate that any provider (with some exceptions) who serves Medicaid beneficiaries must register with AHCCCS.
To make the ROPA registration process as simple as possible, AHCCCS will develop a streamlined application for ROPA providers who meet all of the following criteria:
December 14, 2021
The Arizona Health Care Cost Containment System (AHCCCS) has awarded a new contract to Public Consulting Group (PCG) to administer the Medicaid School-Based Claiming (MSBC) Program from July 1, 2022 through June 30, 2025. The initial term of the contract is three years with two one-year options to extend, not to exceed a total contracting period of five years.
December 1, 2021
On Tues., Nov. 30, the Federal District Court in Louisiana enjoined the CMS vaccine mandate nationally, blocking enforcement of the CMS vaccine mandate and the CMS Interim Final Rule (IFR) which was published in the Federal Register on November 5. The ruling blocks enforcement of the CMS vaccine mandate and applies across the country. Arizona was a party to the Louisiana lawsuit, along with the following Plaintiff States: Louisiana, Montana, Alabama, Georgia, Idaho, Indiana, Mississippi, Oklahoma, South Carolina, Utah, West Virginia, Kentucky, and Ohio.
November 24, 2021
The Federal Emergency Management Agency (FEMA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have approved a 90-day extension of the grant that funds the Crisis Counseling Program and ResilientArizona.org, extending services through March 2, 2022.
In response to the COVID-19 public health emergency, the Crisis Counseling Program immediate service and regular service grants provided services to assist individuals and communities in recovering from the challenging effects of natural and human-caused disasters through the provision of community based disaster relief, outreach, and education.
November 15, 2021
Today, the Arizona Health Care Cost Containment System (AHCCCS) announced the award of expanded contracts to three AHCCCS Complete Care (ACC) health plans to provide integrated physical and behavioral health services to Medicaid members who have a Serious Mental Illness (SMI) designation.
These services are currently provided by contracted health plans known as Regional Behavioral Health Authorities (RBHAs). These awarded contract expansions, known as Regional Behavioral Health Agreements, expand the existing ACC contracts with Mercy Care, Arizona Complete Health (AZCH), and Care1st Health Plan Arizona, Inc. (Care1st), by Geographic Service Area (GSA) (see table below). The additional contract requirements are effective Oct. 1, 2022.
Through this contract expansion, the existing health plans will provide integrated services to individuals with SMI designations; non-Title XIX/XXI state and grant funded services; statewide crisis services for all Arizonans; and Court Ordered Evaluations when contracted by certain Arizona counties.
November 10, 2021
During the COVID-19 public health emergency (PHE), AHCCCS adjusted the provider screening requirements in order to maintain our active provider directory and ensure members had continuous access to health care services. AHCCCS also launched the new Provider Enrollment Portal, APEP.
After implementing APEP in August 2020, AHCCCS asked providers to “re-register.” All active providers were asked to create an account in APEP and confirm the data converted into the new portal is accurate and current. AHCCCS has not terminated providers during the PHE for non-compliance with this re-registration process.
Over the past 15 months, providers have received a written invitation by the US Postal Service that includes a temporary 14-digit application ID and instructions to create a user account to access their file. AHCCCS also transitioned away from paper-based updates, and encouraged providers to submit their updates directly into APEP. For many providers who have not completed the re-registration process, the paper update is being returned with instructions to report the update directly into APEP through the re-registration process.
November 5, 2021
The Arizona Health Care Cost Containment System (AHCCCS) has awarded a contract to begin the strategic planning and modular roadmapping of a full system overhaul of the Prepaid Medicaid Management Information System (PMMIS), a 30-year old mainframe computer system that manages all of the critical Medicaid business functions for Arizona and Hawaii.
The awarded contractor, NTT Data, LLC, will create a holistic roadmap inclusive of technological, budgetary, staffing, and business process challenges that both states will face as they convert from a single, monolithic mainframe system into the modular approach preferred by the Centers for Medicare and Medicaid Services (CMS). With the roadmap, AHCCCS will develop advance planning, requirements, and design documents that CMS and state authorities require before an overhaul can begin.
November 2, 2021
AHCCCS recently received approval to broaden the array of health care services available to Medicaid-enrolled students in Arizona. Last month, the Centers for Medicare and Medicaid Services approved an AHCCCS State Plan Amendment extending Medicaid School Based Claiming (MSBC) services to a larger population of Medicaid-enrolled students.
While MSBC has long been available to students who have an Individualized Education Plan (IEP), this approval allows AHCCCS to cover additional school-based services from specialty providers for even more Medicaid-enrolled students, now including those with Individualized Family Service Plans and other medically necessary plans of care.
October 27, 2021
AHCCCS received $32.7 million in federal funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) made available through the American Rescue Act Plan (ARPA). This additional funding will be used for services for underinsured, uninsured, or non-Medicaid eligible Arizonans who have a history of active substance use in the last 12 months.
October 19, 2021
Due to the extended COVID-19 public health emergency, and in an effort to ensure that no members experience disruptions in care, the registration deadline for providers who refer, order, prescribe, or attend (ROPA) to Medicaid patients, but who are not registered AHCCCS providers, has been extended through the end of the COVID-19 public health emergency.
October 12, 2021
PHOENIX --The Arizona Health Care Cost Containment System (AHCCCS) announces the launch of a new, web-based, opioid services locator to help Arizonans who are looking for services to treat Opioid Use Disorder and where to find Naloxone, the opioid overdose reversal medication.
“The opioid epidemic remains a major public health challenge in Arizona and throughout the U.S.,” said Governor Doug Ducey. “Increasingly, dangerous fentanyl is crossing the border and fueling overdoses in our communities. Arizona has taken serious action to combat the opioid epidemic, including reducing the number of opioid prescriptions written, reducing the total number of pills dispensed and adding significant new funding for treatment. This fight is far from over, and this locator tool is another step to help Arizonans find the treatment they need.”
October 6, 2021
In accordance with Arizona Revised Statutes § 36-136(C), the Arizona Health Care Cost Containment System (AHCCCS) is holding an online public hearing on Tuesday, October 12, 2021, 2:00-3:00 p.m. to gather community and provider input regarding the development of bridge housing on the Arizona State Hospital (ASH) grounds for persons with behavioral health needs who are transitioning from homelessness.
October 5, 2021
CMS has granted partial approval of AHCCCS’ Spending Plan, detailing how the agency will use additional federal funding offered under the American Rescue Plan Act to enhance the state’s home and community based services program. The partial approval allows AHCCCS to start taking advantage of the enhanced 10 percent federal match through March 31, 2022 on qualifying home and community-based services identified in Section 9817 of the ARPA.
October 1, 2021
As part of the work of the Governor’s Abuse and Neglect Prevention Task Force, AHCCCS and the Arizona Department of Economic Security are asking long term care health care providers who serve AHCCCS members to participate in a short survey, available in English and Spanish, conducted by the Sonoran Center for Excellence for Developmental Disabilities (UCEDD).
The survey is anonymous and open through Oct. 15, 2021.
September 30, 2021
The Centers for Medicare and Medicaid Services (CMS) has extended AHCCCS’ 1115 Waiver Demonstration authority for a one-year period, through Sept. 30, 2022, while they continue to review the agency’s 2021-2026 Waiver renewal application.
The extension grants authority to continue specific programs for a sixth year, including the Targeted Investments Program.
September 14, 2021
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic. This funding includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children's Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.
September 10, 2021
AHCCCS has updated its standards for managed care and fee-for-service providers regarding prior authorization and concurrent review during the public health emergency. Find the Sept. 8 guidance for managed care organizations (MCOs), and Aug. 20 guidance for fee-for-service providers in the AHCCCS COVID-19 Frequently Asked Questions under Clinical Delivery question #1.
September 2, 2021
Through funding first appropriated during the 2020 Arizona Legislative session, children enrolled in a pre-K through grade 12 school who are underinsured or uninsured can continue to receive behavioral health care services at little to no cost.
“The action the Arizona State Legislature took in 2020 broadens access to behavioral health services for children, offering even more support to students as they return to the classroom after the pandemic,” AHCCCS director Jami Snyder said. “We are encouraged that Arizona is making strides toward integrating mental health care services as a vital component of overall health and optimal wellness.”
The Children's Behavioral Health Services Fund, administered by the Arizona Health Care Cost Containment System (AHCCCS), provides behavioral health care services to students regardless of insurance coverage. Services can include counseling, therapy, and other treatments for common mental illnesses like anxiety, depression, and other mental health issues students face.
August 31, 2021
AHCCCS announces the appointment of Kasey Rogg to the position of AHCCCS General Counsel and the dual leadership role of Assistant Director of the Office of Administrative Legal Services (OALS), effective September 7, 2021. In addition to a clear commitment to the AHCCCS mission, Kasey brings state government experience, valuable legal expertise, and a proven track record of success to the role. Kasey succeeds Matt Devlin, who retired in July after 22 years of distinguished service with the agency and 25 years with the State.
August 26, 2021
During National Suicide Prevention Awareness Month in September, the Arizona Health Care Cost Containment System (AHCCCS) is working with state agencies, organizations, and coalitions to educate citizens about the role that we all play in preventing suicide. Governor Doug Ducey proclaimed September Suicide Prevention Awareness Month in Arizona, citing that:
August 19, 2021
As part of the work of the Governor’s Abuse and Neglect Prevention Task Force, AHCCCS and the Arizona Department of Economic Security are asking long term care health care providers who serve AHCCCS members to participate in a short survey conducted by the Sonoran Center for Excellence for Developmental Disabilities (UCEDD).
The survey responses will help the Abuse and Neglect Prevention Task Force identify current strengths and opportunities within the care delivery system, and make recommendations for future enhancements, including establishment of benchmarks and target metrics.
August 12, 2021
Renters and landlords in need of financial assistance can use a new website, AHCCCS COVID-19 Frequently Asked Questions, from the Consumer Financial Protection Bureau to find rental assistance providers in your area.
If you know of a renter who’s having trouble paying rent, utilities, or other housing costs – or a landlord trying to stay afloat with tenants in this situation – help may be available. State and local programs are distributing billions of dollars in rental assistance to help renters stay housed during the pandemic.
August 9, 2021
AHCCCS has adopted date-specific payment rates for COVID-19 vaccine administration. The new rates are posted in the AHCCCS COVID-19 Frequently Asked Questions under the COVID-19 Vaccine category.
August 6, 2021
AHCCCS is seeking proposals from current AHCCCS Complete Care managed care contractors interested in serving members with a designation of serious mental illness, offering crisis services, and facilitating the provision of services for non-Medicaid enrolled individuals as well as other non-Medicaid funded services. Historically, this population has been served by Regional Behavioral Health Authorities (RBHAs) in one of the three geographic service areas maintained by AHCCCS.
July 27, 2021
The Health Resources & Services Administration (HRSA) reminds entities that provide health care that American Rescue Plan Act grant funding is available through the Health and Public Safety Workforce Resiliency Training Program.
As described by HRSA, these grant funds can be used to "plan, develop, operate or participate in health professions and nursing training activities using evidence-based or evidence-informed strategies, to reduce and address burnout, suicide, mental health conditions and substance use disorders and promote resiliency among health care students, residents, professionals, paraprofessionals, trainees, public safety officers, and employers of such individuals, collectively known as the “Health Workforce,” in rural and underserved communities."
July 15, 2021
AHCCCS seeks feedback from Arizonans who have called a crisis line to get help for themselves or others. Please take this short survey to privately share your experiences with crisis lines in Arizona. We want to know—what worked well and what could go better?
The survey closes August 31, 2021.
July 12, 2021
On July 12, AHCCCS submitted a proposal to the Centers for Medicare and Medicaid Services (CMS) detailing the agency’s plan for reinvesting federal funding made available through the American Rescue Plan Act (ARPA). The spending plan includes strategies that seek to strengthen AHCCCS’ existing home and community based services (HCBS) program which serves individuals with disabilities and/or serious mental illnesses, individuals who are elderly, and children with behavioral health needs.
July 8, 2021
The Health Resources & Services Administration (HRSA) reminds providers who received one or more payments exceeding, in the aggregate, $10,000 in Provider Relief Funds (PRF) during a Payment Received Period that they are required to report as part of the post-payment reporting process. The Provider Relief Fund Reporting Portal is now open for reporting on the use of funds. Providers required to report during Reporting Period 1 have until September 30, 2021 to submit their information in the portal.
July 7, 2021
AHCCCS has published a new web page with details of the Arizona Olmstead Plan so that interested stakeholders can learn more about historic and current Olmstead-related activities and get involved in Olmstead planning. Members, family members, providers, and others are encouraged to complete a survey to provide input on the availability and accessibility of community-based services. The survey responses will inform a preliminary draft of the Olmstead Plan that will be presented for public comment. Visit the new web page at www.azahcccs.gov/Olmstead for more information, to view the Olmstead planning timeline (under the Current Olmstead Planning Efforts menu), and to subscribe to the email alert list.
June 28, 2021
Through the State Opioid Response (SOR) grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), AHCCCS is funding a new recovery support service, The Barbell Saves Project, at the Recovery Wellness Center.
Designed as a community-based exercise program, The Barbell Saves Project builds a sober exercise environment to support individuals in recovery and encourage overall wellness. Operating at the Recovery Wellness Center at 2806 W. Cactus Rd. in Phoenix, the coaches at The Barbell Saves Project provide peer support and fitness expertise to improve physical and mental well-being and encourage a sober and healthy lifestyle. The classes focus on strengthening the community and increasing overall health for each participant.
June 25, 2021
The Centers for Medicare and Medicaid Services (CMS) has withdrawn federal approval of the AHCCCS Works Community Engagement Program, a proposed demonstration project under the Section 1115 Waiver to implement work requirements for some adults in order to maintain Medicaid eligibility. CMS had approved the demonstration project on January 18, 2019, however AHCCCS postponed implementation in October, 2019 due to ongoing litigation in other states regarding work requirements, and the subsequent COVID-19 pandemic.
Arizona State Statute 36-2903.09 requires AHCCCS to request waiver approval annually from CMS to implement work requirements and limit benefits to five years.
June 16, 2021
PHOENIX -- The Arizona Health Care Cost Containment System (AHCCCS) received platinum level recognition for the third consecutive year from the statewide Healthy Arizona Worksites Program for demonstrating data-driven programming and leveraging cross-sector collaborations to improve the health, well-being and equity of employees and the community. The platinum level award recognizes organizations making an impact both within and beyond their walls addressing one or more of the many health challenges impacting communities across the state.
“This year, with the drastic business changes we were forced to make to address the COVID-19 emergency, earning recognition as a Healthy Arizona Worksite is especially meaningful,” said Jami Snyder, AHCCCS director. “As our work at home environment continued throughout 2021, AHCCCS employees reported increased work/life balance and job satisfaction. I am proud of the AHCCCS team for not only being active participants as remote work employees, but also sharing and promoting those values in the community.”
June 01, 2021
Effective October 1, 2021, the Medicaid School Based Claiming (MSBC) program will cover all Medicaid-enrolled children in participating Local Education Agencies (school districts). This change recognizes the growing need to provide medical and behavioral health services and support to children where they spend the majority of their time—in school.
With this change, Local Education Agencies will have more flexibility in their school-based Medicaid programs by allowing school districts to bill Medicaid for medical or behavioral health services delivered to all Medicaid-enrolled children, not just those with a special education plan documented by an Individualized Education Plan (IEP). AHCCCS will also add specialty providers to the program in order to better serve students in schools.
May 27, 2021
Due to the continuing public health emergency and in an effort to ensure that no AHCCCS member experiences disruptions in care, AHCCCS will further extend the registration deadline for referring, ordering, prescribing and attending (ROPA) providers to January 1, 2022 or the end of the COVID-19 public health emergency, whichever comes later.
May 21, 2021
AHCCCS is hosting an online community forum on June 7 at 5 p.m. to solicit feedback from stakeholders about the American Rescue Plan Act (ARPA) home and community based services (HCBS) expenditure enhancement.
AHCCCS will use the feedback to submit a spending plan to the Centers for Medicare and Medicaid Services (CMS) by June 12, 2021.
Section 9817 of ARPA provides a 10 percentage point increase in federal matching funds (capped at 95 percent) to help implement or expand activities to enhance HCBS. States can use the federal funds from the increased FMAP to supplement, not supplant, existing state funds expended for Medicaid HCBS as of April 1, 2021. States must match the federal funds from the increased FMAP with state funds to implement or supplement one or more activities to enhance, expand, or strengthen HCBS under the State’s Medicaid program.
May 3, 2021
Phoenix - The Arizona Health Care Cost Containment System (AHCCCS) joins Governor Doug Ducey and other state agencies in recognizing May as Mental Health Awareness Month. Through the combined efforts across many state agencies, the State of Arizona is working to increase awareness and understanding of mental health, support prevention efforts, and reduce the stigma surrounding mental health conditions.
Statistics indicate nearly 1 in 5 American adults will have a diagnosed mental health condition in any given year. According to the Centers for Disease Control, suicide was the eighth leading cause of death in Arizonans ages 10-34 in 2019.
Behavioral health crisis services are available to any Arizona resident, regardless of health insurance coverage. If you or someone you know is experiencing a behavioral health crisis, please see the AHCCCS crisis web page for national and county resources.
Arizona Project AWARE provides free, evidenced-based suicide prevention training for educators. The training is approved by AHCCCS and meets legislative requirements, per A.R.S. 15-120. Learn more at azed.gov/wellness/projectaware.
April 30, 2021
The Federal Emergency Management Agency (FEMA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have approved a 6-month extension of the grant that funds the Crisis Counseling Program and ResilientArizona.org, extending services through December 2, 2021. The total amount of funding is more than $3,333,200.
In response to the COVID-19 public health emergency, the Crisis Counseling Program immediate service and regular service grants provided services to assist individuals and communities in recovering from the challenging effects of natural and human-caused disasters through the provision of community based disaster relief, outreach, and education.
AHCCCS was originally awarded the Crisis Counseling Program grants in June 2020 to launch ResilientArizona.org. Since then, both grants have served more than 8,000 unique individuals statewide and reached more than 41,000 other contacts through hotline, helpline, lifeline, and other telephone contact; e-mail contact; community networking and coalition building; materials distributed; mass media; and social networking messages.
April 29, 2021
We are asking AHCCCS members, their families, and registered providers to submit questions about various evidence-based practices that support health outcomes.
Please ask your anonymous questions about:
We want to know how these practices affect members and providers and how the Medicaid program can better incorporate them into service delivery.
Ask as many questions as you have! The survey does not limit the number of responses.
Please take this short survey by May 10.
Then, tune into a series of hour-long sessions hosted by WICHE subject matter experts to hear answers to your questions. Please register in advance by clicking the links below.
April 16, 2021
AHCCCS is conducting a survey to determine the performance and responsiveness of its contracted managed care organizations (MCO) to providers. We are asking providers who are contracted with the health plans listed below to complete this survey by May 17.
Responses will help AHCCCS determine levels of satisfaction with MCO Claims, Customer Service, Credentialing and Prior Authorization processes.
Providers contracted with the following MCO’s are asked to participate:
April 13, 2021
PHOENIX — The Arizona Health Care Cost Containment System (AHCCCS), in partnership with Crisis Response Network, announces a new COVID-19 appointment and transportation navigation program for Medicaid members. Now, Medicaid members who need assistance scheduling a COVID-19 vaccine appointment, as well as transportation to and from that appointment, can call 1-844-542-8201, 8 a.m. to 5 p.m., seven days a week.
“With COVID-19 vaccines now widely available, AHCCCS is working to ensure that its 2.1 million enrolled members have the opportunity to schedule and attend a vaccine appointment, and that technology and transportation do not present any barriers to receiving the vaccine,” Jami Snyder, AHCCCS director, said.
April 5, 2021
AHCCCS published final decisions detailing the Differential Adjusted Payments (DAP) strategies to be implemented in the contract year October 1, 2021 through September 30, 2022 (CYE 2022) for select AHCCCS registered Arizona providers that meet agency established performance criteria.
March 26, 2021
AHCCCS seeks waiver and expenditure authority from the Centers for Medicare and Medicaid Services (CMS) on two waiver demonstration projects.
The AHCCCS Housing and Health Opportunities (H2O) demonstration seeks to enhance and expand housing services and interventions for AHCCCS members who are homeless or at risk of becoming homeless. With this waiver approval, AHCCCS will work to:
See the Addressing Health Care and Housing infographic and read more on the H2O Demonstration Proposal webpage.
March 11, 2021
During the COVID-19 public health emergency (PHE), AHCCCS has implemented more than 47 programmatic changes in order to ensure access to care for members and to maintain the ongoing viability of its provider network.
The status of each of those requests is posted in the “Status of AHCCCS Emergency Authority Requests” document on this AHCCCS web page.
Although the Home and Community Based programmatic changes were due to expire March 12, 2021, the Centers for Medicare and Medicaid Services (CMS) has issued assurance that the authority to continue these changes (known as Appendix K) will be extended for Arizona at least until the PHE ends.
February 25, 2021
In December 2020, under the Consolidated Appropriations Act of 2021, access to full Medicaid benefits was restored for citizens from the following Compact of Free Association (COFA) countries.
Citizens of these countries living in Arizona may be eligible for full Medicaid benefits. There are several ways to submit an application:
Important Information for COFA Applicants
AHCCCS is updating the HEAplus online application system in order to correctly identify and determine full services eligibility for COFA citizens. Since the HEAplus online application does not yet recognize COFA applicants as "qualified" noncitizens, selecting a COFA status will screen the customer for federal emergency services (FES) only.
February 22, 2021
PHOENIX — Governor Doug Ducey and AHCCCS, Arizona’s state Medicaid agency, today announced a first-in-the-nation initiative that will make it easier for Medicaid members to get transportation to drive-through COVID-19 vaccination appointments.
Beginning today, AHCCCS will reimburse non-emergency medical transportation (NEMT) providers for driving eligible Medicaid members to and from their COVID-19 vaccination appointments, including reimbursement for time spent waiting during the drive-through vaccination process.
“We are committed to making the COVID-19 vaccine accessible to all Arizonans,” said Governor Ducey. “This change will make it easier for our most vulnerable Arizonans, individuals with disabilities and those with chronic and long-term care needs, to get vaccinated. Arizona is thrilled to be the first state in the nation to implement this rate reimbursement innovation, and we will continue expanding access to the vaccine as supply increases. I’m grateful to AHCCCS for pioneering this change and their work to serve vulnerable Arizonans.”
This is possible thanks to a temporary rate change, effective today, Feb. 22, 2021, that will cover the cost of transportation for eligible AHCCCS members who have appointments at drive-through vaccination sites. In accordance with federal guidelines, Medicaid members who cannot provide or arrange their own transportation have access to non-emergency transportation (NEMT) to and from appointments for covered Medicaid services.
February 17, 2021
AHCCCS, Arizona’s Health Information Exchange and 2-1-1 Arizona Team Up to Address Social Determinants of Health (SDOH) Screening & Referrals
Health Current, Arizona’s health information exchange (HIE), today announced the selection of NowPow as the vendor of choice for Arizona’s closed loop referral system (CLRS) to address social determinants of health (SDOH) needs in Arizona. By connecting healthcare and community service providers on a single statewide technology platform, this new service promises to streamline the referral process, foster easier access to vital services, and provide confirmation when social services are delivered.
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s state Medicaid agency, launched its Whole Person Care Initiative (WPCI) to focus on the social factors that have an impact on individual health and well-being, such as housing, employment, criminal justice, non-emergency transportation, and home and community-based services interventions. As part of the WPCI strategy, AHCCCS partnered with Health Current to implement a technology solution that can support providers, health plans, community-based organizations (CBOs) and community stakeholders in meeting the social service needs of Arizonans.
In concert with AHCCCS, and in collaboration with 2-1-1 Arizona, which is operated by Crisis Response Network (CRN), Health Current embarked on an extensive evaluation process of available technology vendors who possess the capabilities to develop a single, statewide solution that:
“We are thrilled to work with NowPow on this critically important service that promises to better connect healthcare providers and community-based organizations in Arizona,” said Melissa Kotrys, CEO of Health Current. “The robust capabilities of their technology solution, combined with their proven track record of success in other states, made NowPow an ideal collaborator for this initiative,” she added.
Arizona’s healthcare leadership at the state-level echoes this sentiment. “The SDOH closed loop referral system is foundational to our Whole Person Care Initiative,” said AHCCCS Director, Jami Snyder. “As Arizona’s trusted HIE, Health Current is the ideal community organization to implement this necessary technology. And by Health Current and 2-1-1 Arizona joining forces, we see this as a real opportunity to link current community resources with individuals’ social needs, ultimately resulting in improved member health and wellness,” adds Snyder.
February 2, 2021
PHOENIX—The Arizona Health Care Cost Containment System (AHCCCS) has awarded a three-year contract to Arizona Behavioral Health Corporation (ABC) to administer its AHCCCS Housing Program (AHP) which consists of the permanent supportive housing and housing support programs for individuals with mental health issues who are experiencing homelessness. The contract period is October 1, 2021 through September 30, 2024.
“By choosing a single statewide housing administrator, AHCCCS is prioritizing efforts to standardize and improve housing practices, reduce barriers for members, increase accountability, and most importantly, improve the housing experience as a critical resource in addressing social risk factors, especially for those persons living with mental health issues and experiencing homelessness,” said Jami Snyder, director of AHCCCS.
ABC and its sub-contractor HOM, Inc., have over twenty years experience in providing housing administration and coordinating services through the behavioral health system for persons determined SMI and experiencing homelessness. As the AHP administrator, ABC will be responsible for management and administration of AHCCCS permanent supportive housing subsidies, including, establishing a referral process,waitlist management, verification of eligibility, member briefings, fair market rent determinations, housing quality standards inspections, legal compliance, subsidy payments to landlords and providers, member recertifications, eviction prevention, and housing reporting. ABC will provide these services statewide.
January 28, 2021
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), recently announced that it has amended the reporting timeline for the Provider Relief Fund Program (PRF) due to the recent passage of the Coronavirus Response and Relief Supplemental Appropriations Act.
These reporting requirements will apply to providers who received the Medicaid PRF funds. The reporting requirements do not apply to funds from:
PRF recipients may begin registering for gateway access to the Reporting Portal where they will ultimately submit their information in compliance with the new reporting requirements HHS is issuing.
January 26, 2021
The Tribal ALTCS team recently launched a new, digital resource for Tribal ALTCS providers. The Tribal ALTCS Case Management Digital Tool Box (DTB) is a centralized resource of the forms, tools, lists, and policies that Tribal ALTCS program employees need in order to perform their work. The DTB includes innovative features, including a dedicated quarterly report submission portal, a training center with video and slide deck presentations, helpful hints for utilizing certain PMMIS screens, points of contact for each tribal plan, one-click access to the Tribal ALTCS Member Handbook, and schedules for Tribal ALTCS quarterly meetings and quarterly report submission dates.
January 22, 2021
The Families First Coronavirus Response Act and the CARES Act authorized federal reimbursement for COVID-19 testing, treatment, and vaccine administration for any uninsured individual.
US Department of Health and Human Services, Health Resources & Services Administration (HRSA) developed the COVID-19 Uninsured Program Portal to provide reimbursement at Medicare levels to providers and facilities for coronavirus-related testing and treatment under the COVID-19 Uninsured Program.
Providers who have conducted COVID-19 testing to uninsured individuals, provided treatment for uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020, or administered COVID-19 vaccines to uninsured individuals can begin the process to file claims for reimbursement.
January 13, 2021
On January 13, 2021, AHCCCS notified sub-recipients of SAMHSA grant funding of the following requirements to meet the standards and requirements for financial management systems as delineated in 45 CFR Part 75 Subpart D.
During the COVID-19 pandemic, AHCCCS moved more than 60 percent of its workforce to permanent “virtual offices” and reduced physical office space in Phoenix by half.
January 11, 2021
In February 2021, AHCCCS will reduce its Phoenix office space by half, saving $1.2 million annually.
Since the start of the COVID-19 public health emergency, the majority of AHCCCS employees have been working remotely. Once the public health emergency ends and in-office work environments are again safe, more than 60 percent of employees in the Central Phoenix office will continue to work from "virtual offices," thus allowing the agency to consolidate its physical footprint.
AHCCCS uses the Arizona Management System framework to carefully monitor productivity levels throughout all areas of its business processes. Metrics indicate that in many areas across the agency productivity performance has improved following the transition to virtual offices.
“With the Arizona Management System, our leadership team has been able to see, in near real-time, productivity changes during the transition to work at home,” said Jami Snyder, director of AHCCCS. “Since March, AHCCCS teams have found new ways to work, relying less on printing and storing physical paper, moving functions into an online environment, and eliminating inefficiencies that had become an ingrained part of a physical office space culture.”
January 8, 2021
AHCCCS submitted its 1115 Waiver demonstration renewal request to Centers for Medicare and Medicaid Services (CMS) on December 22, 2020. The final renewal packet, including a summary of the public comments received, can be found on the AHCCCS Waiver Renewal web page. The current demonstration expires on Sept. 30, 2021.
AHCCCS is seeking a five year extension of many existing demonstration authorities.
November 2, 2020
On Oct. 27, the Arizona Health Care Cost Containment System (AHCCCS) received federal approval from the Centers for Medicare and Medicaid Services (CMS) to increase Arizona hospital reimbursement rates by more than 30 percent.
The Hospital Enhanced Access Leading to Health Improvements Initiative (HEALTHII) will result in a net increase in payments to eligible Arizona hospitals of approximately $800 million in the first year of implementation, a more than 30 percent effective rate increase over current reimbursement rates.
“AHCCCS and CMS have worked for the past year to implement this significant and impactful program for hospitals,” Jami Snyder, AHCCCS director, said. “Hospitals have been hit especially hard during the COVID-19 public health emergency; this rate increase approval comes at a time when our hospitals need it most.”
October 28, 2020
In light of COVID-19 public health emergency and priority efforts it has demanded of public health systems, AHCCCS has extended the ROPA registration deadline to June 1, 2021.
The Patient Protection and Affordable Care Act (ACA)and the 21st Century Cures Act (Cures) require that all health care providers who refer AHCCCS members for an item or service, who order non-physician services for members, who prescribe medications to members, or who attend/certify medical necessity for services and/or who take primary responsibility for members’ medical care, must be registered* as AHCCCS providers. AHCCCS calls this initiative, and these providers, "ROPA.”
October 27, 2020
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has expanded Phase 3 Provider Relief Funding to include provider applicants such as residential treatment facilities, chiropractors, and eye and vision providers that have not yet received Provider Relief Fund distributions. These providers and all Phase 3 applicants will have until 11:59 p.m. EST on November 6, 2020 to submit their applications for payment consideration.
October 26, 2020
On Oct. 13, 2020, the United States District Court granted preliminary approval of a settlement agreement that would resolve a class action lawsuit filed against the Arizona Department of Child Safety in 2015 by Children’s Rights, Inc. in which AHCCCS is named.
The agreement will benefit the state by avoiding costly, ongoing court oversight of its child welfare system, and will allow DCS to focus all of its attention and resources on further improving services for children and families.
October 7, 2020
On August 31, 2020, Governor Ducey announced a plan of action to increase influenza vaccination rates and urge Arizonans to get the flu shot. As part of these efforts, the Arizona Health Care Cost Containment System (AHCCCS) is implementing a multi-pronged strategy to: enable certified pharmacists to administer the flu vaccine to children currently enrolled in AHCCCS; increase payments to providers for flu vaccines and vaccine administration by 10 percent; and provide a $10 gift card to all managed care members who obtain an influenza vaccination.
October 5, 2020
Arizona will receive more than $31.6 million per year for two years to provide prevention, treatment, and recovery services to individuals affected by opioid use disorders and/or stimulant use disorders.
Using the State Opioid Response II (SOR II) two-year grant, provided by the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, the Arizona Health Care Cost Containment System (AHCCCS) will administer work with other state agencies, contracted health plans, and community partners to address specific initiatives that:
Efforts will focus on populations that have identified unmet needs, including individuals in rural and isolated areas; veterans, military service members and military families; pregnant women and parents with opioid use disorder; individuals experiencing homelessness; tribal populations; individuals who have experienced trauma, toxic stress or adverse childhood experiences; and individuals re-entering the community from correctional settings.
October 1, 2020
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making $20 billion in new funding available to providers on the frontlines of the coronavirus pandemic.
Under this Phase 3 General Distribution allocation, a large number of providers are eligible to receive funds, including:
October 1, 2020
The Arizona Health Care Cost Containment System (AHCCCS) will submit a five-year renewal proposal of its 1115 Demonstration Waiver to the Centers for Medicare and Medicaid Services (CMS) in December 2020. Section 1115 of the Social Security Act gives the U.S. Secretary of Health and Human Services authority to approve Demonstration Projects that promote the objectives of the Medicaid program and the Children’s Health Insurance Program (CHIP). In Arizona, the CHIP program is known as KidsCare. This flexibility allows states to test innovative approaches to health care in an effort to improve quality, access, and efficiency.
AHCCCS is required to renew its 1115 Waiver with CMS every five years. In the waiver renewal request, AHCCCS outlines its proposed new and ongoing programmatic authorities. With CMS’ approval, the agency will continue to build on the successes of its existing care delivery model, extending authority for Arizona to implement programs including, but not limited to:
September 17, 2020
AHCCCS is required to renew its 1115 Waiver with the Centers for Medicare and Medicaid Services (CMS) every five years and will submit its waiver renewal request in December 2020. The waiver renewal request is the agency’s proposal to CMS outlining new and ongoing programmatic authorities. The COVID-19 public health emergency has shifted the agency’s focus to maintaining current services for our members and providers. Given that, and anticipated budgetary limitations, AHCCCS has elected to shift course and focus on a series of smaller-scale, cost-effective initiatives within the parameters of the existing Medicaid program and refrain, at this time, from the pursuit of a broader Whole Person Care Initiative in conjunction with its five-year 1115 Waiver renewal.
For example, AHCCCS and Health Current, Arizona’s Health Information Exchange (HIE), are sourcing a new technical tool for providers— a closed-loop referral system so providers can identify social risk factors and manage referrals to community based agencies who can address those specific needs.
September 9, 2020
In August, AHCCCS received an additional $2.4 million in federal grant funding extensions that will continue crisis counseling services for Arizonans affected by COVID-19.
The Federal Emergency Management Agency (FEMA) extended $118,651 in grant funding for the Immediate Services Program/Crisis Counseling Program to provide crisis counseling services through September.
In addition, the Substance Abuse and Mental Health Services Administration (SAMHSA) extended another $2,291,051 to provide COVID-19 crisis counseling services through the Regular Services Program/Crisis Counseling Program. This money allows services to move from the Immediate Services Program to the Regular Services Program through June 2021.
August 31, 2020
On August 31, 2020, Governor Ducey announced a plan of action to increase influenza vaccination rates and urge Arizonans to get the flu shot. As part of these efforts, the Arizona Health Care Cost Containment System (AHCCCS) is implementing a multi-pronged strategy to: enable certified pharmacists to administer the flu vaccine to children currently enrolled in AHCCCS; increase payments to providers for flu vaccines and vaccine administration by 10 percent; and provide a $10 gift card to all managed care members who obtain an influenza vaccination. For more information, please visit the link below:
August 26, 2020
The Patient Protection and Affordable Care Act (ACA) and the 21st Century Cures Act (Cures) require that all health care providers who provide services to, order (refer), prescribe, or certify health care services for AHCCCS members must be enrolled as an AHCCCS provider.
Until these Acts passed, referring, ordering, prescribing and attending providers were required to obtain a National Provider Identifiers (NPI’s) but were not required to be enrolled as an AHCCCS provider.
After Jan. 1, 2021 claims which include referring, ordering, prescribing or attending providers who are not enrolled with AHCCCS will not be reimbursed.
August 25, 2020
Since the start of the Public Health Emergency (PHE) in March 2020, AHCCCS suspended all Medicaid disenrollments (unless a member moved out of state, voluntarily disenrolled, died, or aged out of KidsCare), per federal requirements. The PHE is scheduled to expire on Oct. 22, 2020 unless the United States Secretary of the Department of Health and Human Services opts to extend it.
In anticipation of the expiration, AHCCCS will begin to request eligibility information from members whose eligibility requires additional information. However, no member will be disenrolled, regardless of eligibility, until after the PHE ends.
August 19, 2020
AHCCCS received a $900,000 grant from the Substance Abuse Mental Health Services Administration (SAMHSA) to increase treatment services and support for pregnant and postpartum women with substance use disorders.
Grant funding will be used throughout the state to ensure that women with substance use disorder, including opioid use disorder, who are pregnant or postpartum, have access to needed health services and feel supported in their recovery journey. The grant aims to increase outreach, engagement, screening, and assessments among this population.
August 5, 2020
AHCCCS received approval from the Federal Emergency Management Agency (FEMA) for an additional $325,296 in federal grant funds to provide crisis services related to the COVID-19 public health emergency. Crisis counseling services will continue through the funding extension of August 28, 2020.
The grant funding extension allows Crisis Response Network to continue providing Immediate Program Services/Crisis Counseling Program (ISP/CCP) services and public education through the ResilientArizona.org Crisis Counseling program.
August 4, 2020
The AHCCCS Online Provider System will be unavailable for 48 hours from Friday, Aug. 7 at 5 p.m. through Sunday, Aug. 9, at 5 p.m. for planned system maintenance and upgrades to align with current security and privacy standards.
July 31, 2020
The U.S. Department of Health and Human Services (HHS) announced a second extension of the application period for Medicaid and CHIP providers to apply for payments from the Provider Relief Fund (PRF). The new deadline for applications is Friday, August 28.
Further, HHS announced that starting on August 10, providers who received automatic payments from the general distribution (the initial $30 billion from the PRF that HHS distributed based on Medicare FFS utilization) and did not apply to receive additional funds at that time will be given another opportunity to apply. This reopened application period will last from August 10 to August 28. This should allow providers who received nominal payments to apply and receive the intended total payment of two percent of net patient revenue.
July 30, 2020
On July 23, Director Jami Snyder accepted the 2020 Leadership in Policy Award from the ASU Center for Applied Behavioral Health Policy.
“At the beginning of the pandemic, AHCCCS made two commitments,” said Snyder, who accepted the award. “One, ensuring access to care for members during the public health emergency, and two, maintaining the ongoing viability of the provider network.”
Dr. Michael Franczak, Director of Population Health at COPA, presented the award to the AHCCCS leadership team (who attended via webinar), specifically noting the policy changes implemented to address the COVID-19 public health emergency. Reading from the nomination submitted by Mary Jo Whitfield, vice president of behavioral health at Jewish Family & Children’s Service, he cited an extensive, including the agency’s ability to streamline provider enrollment, change the PASRR assessment process, provide continuous eligibility to enrolled members, waive member premiums and co-pays, provide COVID-19 testing reimbursement, and expand respite care.
July 24, 2020
The Arizona Health Care Cost Containment System (AHCCCS) received an $800,000 emergency suicide prevention grant from the Substance Abuse Mental Health Services Administration (SAMHSA) on July 20, 2020. AHCCCS was one of three Arizona awardees of the federal emergencies dollars. SAMHSA awarded the same grant amount to EMPACT-Suicide Prevention Center in Tempe and the Pasqua Yaqui Tribe in Southern Arizona. In total, these grants bring an additional $2.4 million in suicide prevention services to Arizona.
July 9, 2020
In response to concerns voiced by the Coalition of Arizona Pediatric Providers (CAP2I) for Immunizations, AHCCCS continues to actively explore opportunities to request federal authority for programmatic changes.
On July 7, 2020, the agency formally responded to CAP2I
June 26, 2020
AHCCCS recently announced a contract award for maintenance and operations of the Health-e-Arizona Plus (HEAplus) eligibility and enrollment system to Accenture. The contract award is $39 million over five years for maintenance and operations of the system, and $82 million over five years for new development and infrastructure that may occur over the term of the contract, for a total award of $121 million.
HEAplus provides an online system for consumers, eligibility workers, and community assistors. The system supports eligibility determinations and ongoing case management for State programs, including: Medicaid, Children’s Health Insurance Program (CHIP) (known as KidsCare in Arizona), Medicare Savings Program (MSP), Arizona Long-Term Care System (ALTCS), Supplemental Nutrition Assistance Programs (SNAP), Temporary Assistance for Needy Families (TANF), and Arizona’s MyFamilyBenefits (Electronic Benefits Transfer [EBT] Portal).
June 24, 2020
In partnership with the Arizona Department of Health Services (ADHS) and the Arizona Health Care Cost Containment System (AHCCCS) and made possible by Federal Emergency Management Agency Grant funding, Crisis Response Network (CRN) announces that the new Resilient Arizona Crisis Counseling Program launched on June 22, 2020 to provide 100% free and confidential support and connections to resources for Arizona residents impacted by the COVID-19 Pandemic.
Accessible via CRN’s existing 2-1-1 statewide information and referral phone number, the Resilient Arizona Crisis Counseling Program is a bilingual (English and Spanish), federally-funded program that will connect callers to crisis counseling providers in their area throughout the state of Arizona.
The mission of Resilient Arizona CCP is to assist individuals and communities in recovering from the psychological effects of the Coronavirus pandemic through crisis counseling services which include community-based outreach, emotional support and educational services.
June 18, 2020
On June 9, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced $15 billion in additional distributions from the CARES Act Provider Relief Fund available to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs.
June 12, 2020
On June 9, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs.
HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution. HHS also announced the distribution of $10 billion in Provider Relief Funds to safety net hospitals that serve our most vulnerable citizens. The safety net distribution will occur this week.
June 12, 2020
The Secured Behavioral Health Facility grant has been published on the State of Arizona Grants and Federal Resources website under the heading “HCA-DBF Procurement.” Grant applications are due July 16. 2020.
The State of Arizona has recognized that the current continuum of treatment and housing settings for persons determined Seriously Mentally Ill (SMI) may not be sufficient in quantity or programmatic structure to address the treatment needs of civilly committed persons who have an SMI determination and who are chronically resistant to treatment. In addition to their mental health conditions, many of these individuals may be dealing with co-occurring conditions including substance use disorders. This population may also experience other challenges including frequent hospitalization, incarceration or legal involvement, or homelessness and housing instability that complicate behavioral health treatment or service plan goals.
June 8, 2020
AHCCCS is seeking recommendations on quality metrics dashboard reporting for behavioral and physical health for the next three years (Oct. 1, 2020 through Sept. 30, 2023). AHCCCS has recently strategically aligned its quality performance measure monitoring with the CMS Child Core Set, Adult Core Set, and the Medicaid Scorecard. AHCCCS conducts routine performance and utilization review on other metrics that are also available for a dashboard.
June 6, 2020
The Arizona Health Care Cost Containment System (AHCCCS) received Platinum level recognition from the statewide Healthy Arizona Worksite Program for demonstrating data-driven programming and leveraging cross-sector collaborations to improve the health, well-being and equity of employees and the community. The Platinum level award recognizes organizations making an impact both within and beyond their walls addressing one or more of the many health challenges impacting communities across the state.
“Employee well-being not only impacts organizations, it has a ripple effect that can inspire entire communities to focus on whole-person health,” said Jami Snyder, AHCCCS director. “I am proud of the AHCCCS team for not only being active participants at work, but also sharing and promoting those values in the community.”
June 5, 2020
On June 3, 2020, the Federal Emergency Management Agency (FEMA) awarded a Crisis Counseling Immediate Services Program (ISP) grant in the amount of $532,804 to AHCCCS. The grant funds will provide crisis counseling services to the general public who have been affected by the COVID-19 emergency with specific focus on healthcare workers, youth, families, those 65 and older and tribal communities. Individual and group counseling services will be available and public service announcements will be generated to notify the public in how to access services.
June 5, 2020
AHCCCS is required to renew its 1115 Waiver with the Centers for Medicare and Medicaid Services (CMS) every five years, and had been working toward an October 1, 2020 submission deadline for its initial application to CMS. Due to the pandemic, CMS granted AHCCCS a three-month extension. The Waiver renewal application, AHCCCS’ proposal to CMS that outlines the authorities the agency wishes to pursue, will be submitted by the end of the 2020 calendar year.
May 29, 2020
AHCCCS published final decisions for Differential Adjusted Payments (DAP) strategies to be implemented in the contracting year October 1, 2020 through September 30, 2021 (CYE 2021) for select AHCCCS-registered Arizona providers, which meet agency established performance criteria. This final public notice also addresses future DAP reimbursement strategies that may be considered for implementation in CYE 2022 and thereafter. For more information, read the DAP Final Public Notice dated May 27, 2020.
May 8, 2020
AHCCCS and the Governor’s Office of Youth, Faith and Family have made trauma-informed, evidence-based behavioral strategies available to families, educators and communities in partnership with the PAXIS Institute. Through a Substance Abuse and Mental Health Services Administration grant, the PAX Tools are a set of evidence-based, trauma-informed strategies for parents and caregivers scientifically proven to reduce problematic behavior, increase cooperation, and improve relationships between adults and children in the home.
During the COVID-19 emergency while parents are managing their childrens’ education at home, the PAX Tools Recipes are instructions for individual, evidence-based strategies that can support families through the pandemic and beyond. Ultimately, these strategies can reduce instances of child maltreatment and even reduce the risk of psychiatric disorders and drug misuse. These strategies are free to families by completing a PAX Tools Survey.
May 5, 2020
The Families First Coronavirus Response Act authorized federal reimbursement for COVID-19 testing and testing related services for any uninsured individual.
Last week, the US Department of Health and Human Services, Health Resources & Services Administration (HRSA) announced the COVID-19 Uninsured Program Portal. The COVID-19 Uninsured Program will provide reimbursement at Medicare levels to providers and facilities for coronavirus-related testing and treatment of the uninsured. Funding for the program is provided primarily through appropriations to the Provider Relief Fund, as well as $1 billion from the Families First Coronavirus Response Act. The administration has not yet announced how much of the Provider Relief Funds will go towards the program.
To access the funds, health care providers must register to participate in the HRSA program. Once registered, those who have conducted COVID-19 testing or provided treatment to uninsured individuals on or after February 4, 2020 may request claim reimbursement through the portal beginning May 6, 2020.
April 27, 2020
To help health care providers address the COVID-19 emergency and ensure their ongoing viability, the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is advancing more than $41 million in scheduled payments to hospitals, primary care providers, behavioral health outpatient providers, and justice clinic providers who participate in the agency’s Targeted Investments program.
“Arizona’s hospitals, doctors and behavioral health professionals have supported those in need during the COVID-19 health emergency and well before,” said Governor Doug Ducey. “AHCCCS is providing these payments ahead of schedule so we can ensure these health care providers and professionals can continue to serve Arizonans without interruption. My thanks to frontline workers and health care professionals across the state working around the clock to protect public health and safety.”
April 22, 2020
The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded a $2 million grant to AHCCCS on April 16, 2020 to increase behavioral health services in response to the COVID-19 national emergency. The agency’s application, submitted on April 10, requested the grant funding in order to increase treatment services and improve service infrastructure in order to help meet increased community needs statewide.
April 17, 2020
To help health care providers deliver services and do business during the COVID-19 emergency, AHCCCS has compiled several financial and informational resources.
In a combined effort with the Health Information Exchange (HIE), AHCCCS managed care health plans have launched a COVID-19 Information for Providers web page with centralized resources, including critical Arizona state announcements, important FAQs and other relevant documents, trainings, and webinars. If providers have questions about the content on this site they are encouraged to contact their health plan representative.
April 08, 2020
To help Arizona’s hospitals weather the impact of COVID-19, Governor Doug Ducey announced today that the Arizona Health Care Cost Containment System (AHCCCS) will work with its provider partners to make available more than $50 million in accelerated hospital payments and advances and extend an additional $5 million in new COVID-19 related funding to Critical Access Hospitals throughout the state.
“Our hospitals represent the frontlines in the fight against COVID-19,” said Governor Doug Ducey. “We need them operating at full strength, which is why AHCCCS will be advancing these payments ahead of schedule. I’m grateful to AHCCCS Director Jami Snyder for her leadership and to the health care professionals across our state working day and night to provide care to those in need and save lives.”
March 23, 2020
Arizona’s Medicaid agency today received federal approval to implement programmatic changes to help ensure access to health care for kids and vulnerable Arizonans.
Arizona was one of the first states to submit a request to waive certain Medicaid and KidsCare (CHIP) program requirements in order to address the COVID-19 outbreak. The Centers for Medicare and Medicaid Services (CMS) approved components of Arizona’s request under the 1135 Waiver. Under the waiver, AHCCCS will be able to strengthen the provider workforce, remove barriers to care for AHCCCS members, enhance Medicaid services and supports for vulnerable members, and remove burdensome cost-sharing and other administrative requirements.
March 3, 2020
AHCCCS is pleased to announce the execution of an agreement with the University of Arizona (U of A) to make Medicaid demographic data sets available to the University for research purposes. AHCCCS maintains a similar data-sharing agreement with Arizona State University (ASU) Center for Health Information Research (CHIR).
Both contracts are managed through the Arizona Board of Regents. AHCCCS appreciates the support of the Board of Regents and the continued efforts of State Senator Heather Carter to advance an expanded partnership between AHCCCS and the U of A, facilitating the sharing of critical data and allowing for additional research and analysis of various aspects of the state's health care delivery system.
February 21, 2020
AHCCCS is gathering input from providers to assess their capacity to meet the Centers for Medicare and Medicaid Services' (CMS) participation standards for the State Plan Amendment (SPA) and Waiver options. This feedback will inform our decision-making process regarding Institutions for Mental Disease (IMDs). IMD providers are encouraged to complete this survey before Friday, March 6, 2020.
February 3, 2020
On November 18, 2019, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule addressing a variety of issues including Medicaid supplemental payments, methods of financing the non-federal share (including provider taxes and donations) and corresponding State reporting requirements. This proposed Medicaid Fiscal Accountability Rule (MFAR) will have significant implications for the ways in which States finance Medicaid programs and pay for Medicaid services.
The Arizona Health Care Cost Containment System (AHCCCS) prepared a summary document on Jan. 17, and submitted comment to CMS on January 31, 2020 regarding the proposed rule.
January 28, 2020
AHCCCS is currently analyzing policy guidance from the Centers for Medicare and Medicaid Services (CMS) in order to make decisions regarding the state’s ability to offer treatment coverage options for members who receive services in Institutions for Mental Disease (IMDs). IMDs are facilities including hospitals, nursing facilities and other institutions that have more than 16 beds and are primarily engaged in providing behavioral health diagnosis, treatment, or care to adults and children over age 16 in a behavioral health residential treatment setting.
November 29, 2019
The Arizona health care community is embracing electronic prescribing of controlled substances (EPCS) as an important strategy to combat opioid abuse. EPCS eliminates paper prescriptions, which can be stolen, forged or altered. Beginning January 1, 2020, Arizona providers who order a Class II Opioid medication will be required to send it directly to a pharmacy instead of writing a paper prescription. But time is running out for providers to be ready and enabled to prescribe opioids electronically by the first of the year.
November 26, 2019
AHCCCS is seeking public comment on the proposed sale of Steward Health Choice Arizona, Inc. (SHCA) to Blue Cross Blue Shield of Arizona, Inc. (BCBSAZ) and the proposed transition plan. Steward Health Choice Arizona currently serves approximately 203,700 members throughout Maricopa, Pinal, and Gila counties as an AHCCCS Complete Care Plan (ACC Plan), and the entire northern geographic area of the state as both an ACC Plan and a Regional Behavioral Health Authority (RBHA).
November 22, 2019
Growing national attention on social determinants of health (the impact that social factors have on a person’s health and well-being) indicates that socio-economic status, behaviors, and physical environment contribute more to health outcomes than access to health care. AHCCCS has addressed these complex issues through efforts to provide housing, employment, criminal justice, non-emergency transportation and home and community-based services interventions for members, using Medicaid-covered services while also relying on a broad range of funding sources for services and supports not available under the Arizona Medicaid program.
We know, too, that more can be done. As we continue to explore opportunities that support whole person health care, we are engaging community stakeholders who have expressed interest in augmenting our ability to address:
October 15, 2019
AHCCCS, in coordination with the Arizona Department of Education (ADE), announce their selections for school suicide prevention training options, as mandated in Senate Bill 1468. Known as the Mitch Warnock Act, named after a Tempe teenager who died by suicide, the statute states that AHCCCS will select, and post on their website, evidence-based, best practice suicide prevention training materials. School administrators can choose from among these materials as they work toward meeting the statute’s requirements. The law goes into effect at the beginning of the 2020-2021 school year and mandates that all school staff who interact with students in grades 6 through 12 must receive suicide prevention training at least once every three years.
August 28, 2019
Since the effective date of July 1, 2019, AHCCCS covers medically necessary immunizations for individuals 19 years of age and older when the vaccines are administered by AHCCCS registered providers through County Health Departments. These immunizations are covered even if the AHCCCS registered provider is not in the member’s health plan network.
August 28, 2019
In order to expand access to care in rural and metro areas of Arizona, AHCCCS is requesting public comments on proposed changes to the covered telehealth services in AHCCCS Medical Policy 320-I.
August 22, 2019
The Arizona Health Care Cost Containment System (AHCCCS) is seeking public comment regarding the proposed merger agreement between Centene Corporation (“Centene”) and WellCare Health Plans ("WellCare"), which would result in Centene acquiring control of WellCare. In addition, AHCCCS is seeking public comment on the proposed transition plan associated with this proposed merger. Two AHCCCS contracted health plans, Arizona Complete Health-Complete Care Plan and Care1st Health Plan of Arizona, are affected by this proposed merger.
July 24, 2019
AHCCCS is awaiting policy guidance from the Centers for Medicare and Medicaid Services (CMS) in order to make operational decisions regarding the state’s ability to expand treatment coverage options for members who receive services in Institutions for Mental Disease (IMDs). IMDs are facilities including hospitals, nursing facilities and other institutions that have more than 16 beds and are primarily engaged in providing behavioral health diagnosis, treatment, or care to adults and children over age 16 in a residential treatment setting.
May 08, 2019
For the second consecutive year, the Arizona Health Care Cost Containment System (AHCCCS) received Platinum level recognition from the statewide Healthy Arizona Worksite Program for demonstrating data-driven programming and improving health, well-being, and equity in the workplace. The Healthy Arizona Worksite Award recognizes employers that are making efforts to positively affect the health and well-being of their employees, their families and their community by implementing comprehensive worksite wellness strategies.
May 01, 2019
The Arizona Health Care Cost Containment System (AHCCCS) announces a policy change, effective May 1, 2019, that allows Transportation Network Companies (also known as “rideshare” companies) to register as non-emergency medical transportation providers.
April 29, 2019
Governor Doug Ducey bestowed the Good Government award on AHCCCS on April 25, 2019 for the agency’s successful efforts to streamline health care services for the 1.9 million Arizonans who rely on Medicaid for their health care. Jami Snyder, AHCCCS director, accepted the Good Government award from Gilbert Davidson, Chief Operating Officer for the State of Arizona.
April 26, 2019
Beginning in 2020, AHCCCS will require Medicaid providers of personal care and home health services to use Electronic Visit Verification (EVV) pursuant to Section 1903 of the Social Security Act (42 U.S.C. 1396b). EVV is an electronic based system that verifies when caregiver visits occur and documents the precise time services begin and end. It ensures that members receive their medically necessary services. AHCCCS has selected Sandata Technologies LLC to deliver the statewide EVV system that will be made available to all service providers required to use EVV. Service providers may choose to use an alternate EVV system vendor (at their own cost) and must interface with the statewide system as a data aggregator. More information is available on the EVV web page.
March 20, 2019
The Arizona Health Care Cost Containment System (AHCCCS) is accepting applications from licensed Naturopathic Physicians who wish to serve AHCCCS members under Early Periodic Screening Diagnostic and Treatment (EPSDT). This AHCCCS provider type is active and is designated as 17-Naturopath in the AHCCCS Provider Registration system.
March 14, 2019
The Arizona Health Care Cost Containment System (AHCCCS) will hold the bi-annual review of the Arizona State Plan to End Suicide on Monday, March 18, 10 a.m. to noon at the AHCCCS Phoenix office, 701 E. Jefferson, Phoenix. Community members are invited to attend.
“Arizona ranks 17th in the nation in rate of suicide with at least one death by suicide occurring every day. The State Plan to End Suicide is a collaborative effort among various health agencies and advocates to stem the rates of suicide, educate citizens that suicide is preventable, and build awareness of resources available to help those in crisis and in recovery,” said Kelli Williams, Suicide Prevention Administrator for AHCCCS.
March 11, 2019
AHCCCS has partnered with Adaptation Health to organize and present a Medicaid Innovation Challenge on March 29, 2019.
This is an exclusive opportunity for pioneering vendors to collaborate with integrated managed care organizations to discuss what value their solutions can bring to Arizona Medicaid in addressing Social Determinants of Health and Digital Member Engagement.
March 11, 2019
The Arizona Health Care Cost Containment System (AHCCCS) became aware of a breach of personal health information on January 15, 2019 affecting 3,146 individuals in Arizona who receive Medicaid coverage.
Upon becoming aware of the breach, AHCCCS conducted an extensive internal investigation and determined that, due to a programming error, 3,146 IRS 1095-B Forms were misdirected to incorrect physical home addresses.
The IRS 1095-B Form, Health Coverage Statement reports an individual’s enrollment in a qualified health plan. The 1095-B Form contains minimal identifying information. In this particular incident, the forms contained a name in conjunction with date of birth. No social security numbers were included on the form.
At the point of discovery, AHCCCS stopped all subsequent mailings to members until the issue could be rectified and the error corrected. Additional internal procedures have been implemented to ensure that this type of error cannot occur again. On March 11, AHCCCS notified, in writing, those members whose health information was compromised.
February 28, 2019
Arizona is currently in a syphilis outbreak in women and babies. Arizona now has the 5th highest rate of syphilis in the country.
Based on the recommendation from the Arizona Department of Health Services (ADHS), with support from the Center for Disease Control (CDC), the Arizona Health Care Cost Containment System (AHCCCS) is covering three syphilis screenings during pregnancy statewide effective immediately.
February 26, 2019
The Arizona Health Care Cost Containment System (AHCCCS) and the Hawaii’s Med-QUEST Division (MQD), Medicaid program are pleased to announce the joint selection of Sandata Technologies, LLC as the statewide electronic visit verification (EVV) vendor. The two state Medicaid agencies endeavored on the joint procurement because AHCCCS supports the information technology infrastructure for Hawaii. The contract award is contingent upon approval from the Centers for Medicare and Medicaid Services (CMS) and the Arizona Department of Administration, Arizona Strategic Enterprise Technology (ADOA-ASET) which is anticipated to be on or before June 1, 2019 and is subject to change. The conditional notice of award and entire procurement file is available on the AHCCCS website on the AHCCCS Open Solicitations webpage Public Notices under contract number YH19-0025.
February 6, 2019
The AHCCCS Administration has posted a Notice of Public Information of preliminary Differential Adjusted Payments (DAP) for the contracting year October 1, 2019 through September 30, 2020 (CYE 2020). The Administration is proposing to implement these DAP rates to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available at least to the extent that such care and services are available to the general population in the geographic area.
For more information, please see the Public Notices page under Rates & Supplemental Payment, or see Preliminary CYE 2020 Differential Payment notice. Written comments may be submitted to FFSRates@azahcccs.gov no later than 5:00 p.m. on March 4, 2019.
January 18, 2019
The Arizona Health Care Cost Containment System (AHCCCS) received 1115 Waiver Amendment approval from the Centers for Medicare and Medicaid Services (CMS) to implement community engagement requirements for some able bodied AHCCCS members ages 19 to 49, and to limit retroactive coverage for some applicants to the beginning of the month in which the Medicaid application is filed.
The community engagement program, called AHCCCS Works, is designed to encourage qualifying members to use existing community services and resources in order to gain and maintain meaningful employment, job training, education, or volunteer service experience.
January 15, 2019
Director Jami Snyder today announced organizational changes with the following message:
In a state agency that has enjoyed continuity of leadership for the last 17 years, I am honored to serve as the next director of AHCCCS, an agency which stands as a model for Medicaid programs across the country.
AHCCCS will continue to demonstrate our commitment to those we serve – members and families, managed care partners, stakeholders, and taxpayers. Ultimately, our success will be determined by our efforts to support the four goals, and corresponding strategic objectives, outlined in our 2019 strategic plan:
December 31, 2018
Governor Doug Ducey today announced the appointment of Jami Snyder as the director of the Arizona Health Care Cost Containment System (AHCCCS).
Snyder has served as deputy director of AHCCCS since December of 2017. Prior to joining Arizona’s Medicaid agency, she served as Medicaid Director for the state of Texas and as Chief Operating Officer of the University of Arizona Health Plans. She also previously held posts as an Operations Administrator at AHCCCS and a Bureau Chief at the Arizona Department of Health Services. Snyder will succeed Tom Betlach who will retire as Director of AHCCCS on January 4 after 27 years of service to the state of Arizona.
November 16, 2018
AHCCCS announces its contract with Accuity Asset Verification Services, Inc. (Acuity AVS) to streamline the asset verification process of the Arizona Long Term Care System (ALTCS) application. The contract will allow financial institutions to securely transmit an applicant’s account balance to Acuity AVS for verification. This electronic transfer streamlines the application process, reducing the need for applicants or their proxies to obtain and submit bank statements manually. It reduces the possibility of human error and fraud and results in faster ALTCS eligibility determinations.
Financial institutions are encouraged to participate in this secure asset verification system.
November 8, 2018
Governor Doug Ducey today announced that Thomas Betlach, director of the Arizona Health Care Cost Containment System (AHCCCS), will retire in January 2019, after 27 years of distinguished service to the state of Arizona. Mr. Betlach led Arizona’s Medicaid agency for the past nine years and served as its deputy director for the prior eight years.
“Tom is the model of a servant leader, someone whose innovative thinking paired with institutional knowledge motivated and inspired,” said Governor Ducey. “I value his health care and finance expertise, and deeply appreciate all he has done to lead a nationally recognized, cost-effective program that provides quality health care for our state’s most vulnerable populations.”
“It has been my privilege, honor and blessing to serve as the AHCCCS director. I want to express my deep appreciation for the opportunity to serve Arizona and to work with the talented team at AHCCCS who’ve inspired and educated me every day,” said Mr. Betlach. “AHCCCS is an amazing, mission-driven organization that positively impacts every community in our state.”
October 2, 2018
AHCCCS awarded a three-year, $16.4 million contract to CNSI, a health information technology business solutions provider, to modernize its Medicaid Management Information System (MMIS).
September 19, 2018
PHOENIX — Arizona will receive more than $20 million to continue the efforts to combat the nation’s opioid epidemic. The funding is provided by the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), and is the first of a two-year grant for State Opioid Response (SOR). AHCCCS will administer the grant and work with other state agencies, health plans, and community partners to address specific initiatives.
“Arizona has taken serious action in the last year in the fight against the opioid epidemic in our state. Through coordinated efforts and bipartisan legislation, we’ve reduced the number of opioid prescriptions written, reduced the total number of pills dispensed, and have provided significant new funding for treatment,” said Governor Doug Ducey. “We know this fight is far from over and this grant will help more Arizonans receive the support they need.”
September 14, 2018
The AHCCCS Director shared an important message with the AHCCCS community that highlights the member protections during the transition to the ACC contracts.
July 24, 2018
American Indians who are enrolled in Medicaid coverage from the Arizona Health Care Cost Containment System (AHCCCS) will have new integrated health plan choices when AHCCCS Complete Care (ACC) begins Oct. 1, 2018. Under AHCCCS Complete Care, the American Indian Health Program (AIHP) and AHCCCS managed care health plans will provide “integrated care,” or single health care plan options for all physical and behavioral health care services.
June 25, 2018
As administrators of Arizona’s Medication Assisted Treatment – Prescription Drug Opioid Addiction (MAT-PDOA) service grant from the Substance Abuse and Mental Health Services Administration (SAMSHA), the Arizona Health Care Cost Containment System (AHCCCS) will host two MAT Symposiums in Mohave and Graham County this summer.
May 25, 2018
AHCCCS posts Behavioral Health Enrolled & Served monthly reports that identify the number of individuals utilizing behavioral health services under both Title XIX/XXI and non-Title XIX/XXI. Find this report on the AHCCCS Legislative Reports page.
May 23, 2018
For the contracting year October 1, 2018 through September 30, 2019 (CYE 2019), select AHCCCS-registered Arizona providers which meet agency established performance criteria will receive Differential Adjusted Payments (DAP). The AHCCCS Administration is implementing these DAP rates to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available at least to the extent that such care and services are available to the general population in the geographic area.
May 22, 2018
The Arizona Health Care Cost Containment System recently received Platinum level recognition from the statewide Healthy Arizona Worksites Program for demonstrating data driven programming and improving health, well-being, and equity in the workplace. The Healthy Arizona Worksites Award recognizes employers that are making efforts to positively affect the health and well-being of their employees, their families and their community by implementing comprehensive worksites wellness strategies.
May 2, 2018
With one in five 1 Americans experiencing mental illness each year, Arizona is calling attention to the impact that mental health has on everyone’s overall health and well-being. Joining with national and local organizations around the country, Arizona recognizes May as Mental Health Awareness Month, as proclaimed by the Honorable Doug Ducey, Governor of Arizona.
April 9, 2018
The Arizona Health Care Cost Containment System (AHCCCS) has submitted a formal waiver amendment request seeking the authority to limit retroactive coverage for new AHCCCS members to the month of application.
March 5, 2018
The Arizona Health Care Cost Containment System (AHCCCS) has awarded managed care contracts to seven integrated managed care organizations (MCO’s) that will coordinate the provision of physical and behavioral health care services to 1.5 million Medicaid members. Called AHCCCS Complete Care, the contracts begin on Oct. 1, 2018 and are awarded in the following geographic service areas (GSAs):
Central GSA (Maricopa, Gila and Pinal counties, excluding zip codes 85542, 85192, and 85550): Banner-University Family Care Plan, Care1st Health Plan Arizona, Health Choice Arizona (Steward Health Choice Arizona), Health Net Access, Magellan Complete Care of Arizona, Mercy Care, and UnitedHealthcare Community Plan.
South GSA (Pima, Cochise, Graham, Greenlee, La Paz, Santa Cruz, and Yuma Counties, including zip codes 85542, 85192, and 85550): Banner-University Family Care Plan, Health Net Access, and UnitedHealthcare Community Plan (in Pima County only).
North GSA (Mohave, Coconino, Apache, Navajo, and Yavapai Counties): Care1st Health Plan Arizona, Health Choice Arizona (Steward Health Choice Arizona).
February 27, 2018
Mercer, an independent contractor, has completed an analysis of a proposal to integrate behavioral health services for children in foster care who are enrolled in the state’s Comprehensive Medical and Dental Program (CMDP). This report includes the analysis requested by AHCCCS and the Department of Child Safety (DCS) in January 2018 that Mercer examine Administrative Services Organization (ASO) models for Arizona's child welfare and Medicaid agencies and alternative health service delivery systems for children and youth in foster care.
February 20, 2018
The Targeted Investments Program (TI), a 5-year incentive program to help registered AHCCCS providers develop clinical processes that integrate physical and behavioral health care delivery, announces provider participants. More than 515 locations have been accepted from six specialty categories: Adult Behavioral Health, Pediatric Behavioral Health, Adult Primary Care, Pediatric Primary Care, Hospitals, and Justice. All participants are currently working to complete Year Two program milestones.
February 12, 2018
In a Special Session of the Legislature, members of the Arizona House and Senate Legislature unanimously passed the Arizona Opioid Epidemic Act, which Governor Ducey signed into law on January 26, 2018.
The Arizona Opioid Epidemic Act provides funding for treatment, improves oversight and enforcement tools, and extends life-saving resources to law enforcement, first responders, and community partners on the ground.
January 25, 2018
Federal legislation signed into law on Monday, Jan. 22 extends federal funding for the Children’s Health Insurance Program (CHIP, which is called KidsCare in Arizona) for six years, through Sept. 30, 2023. The law also ensures that the federal government will cover 100% of KidsCare costs through Federal Fiscal Year 2019 (ending Sept. 30, 2019). In Arizona, KidsCare currently covers more than 23,000 children who otherwise would not have health insurance.
January 11, 2018
AHCCCS seeks public comments on a Section 1115 Waiver Amendment Proposal to waive prior quarter coverage for new Medicaid enrollees. The proposed waiver amendment would give AHCCCS the flexibility to limit retroactive coverage to the month of application, consistent with standard practice within the private insurance industry and Arizona’s policy prior to the Affordable Care Act.
AHCCCS will accept comments on this waiver amendment proposal through February 25, 2018. In addition to requesting written public comments, AHCCCS will present this waiver proposal at the Tribal Consultation meeting on January 11, 2018, and will host community forums in Phoenix, Tucson, and Flagstaff in order to give the public the opportunity to ask questions and provide feedback regarding this proposal.
See the Prior Quarter Coverage Waiver Amendment webpage for more information and the public forum schedule.
January 10, 2018
An outside independent contractor hired by AHCCCS has completed an analysis of the system’s capacities to integrate the Comprehensive Medical and Dental Plan (CMDP), an AHCCCS acute care health plan for children in foster care, with behavioral health services. The report by Mercer outlines, evaluates, and provides recommendations regarding the operational and administrative considerations that the system must address in order to fully and successfully integrate physical and behavioral health services.
December 19, 2017
The Arizona Health Care Cost Containment System (AHCCCS) has submitted a formal 1115 Waiver Amendment Request to the Centers for Medicare and Medicaid Services seeking authority to implement community engagement requirements and a five-year maximum lifetime benefit limit for a portion of the Medicaid population.
December 5, 2017
The Arizona Health Care Cost Containment System (AHCCCS) introduces Jami Snyder as the state Medicaid agency’s deputy director. Snyder previously served as the Medicaid director for the state of Texas on behalf of the Texas Health and Human Services Commission, overseeing a $29 billion program serving 4.7 million people.
December 4, 2017
In response to increasing behavioral health needs of its populations, AHCCCS is providing funding to ensure ongoing system service capacity and member access to care. As detailed below, funding is provided through the RBHA capitation rates for Contract Year Ending (CYE) 2018 (October 1, 2017 through September 30, 2018) to address issues such as the opioid epidemic and other substance use disorder needs, as well as ensuring access to mandated EPSDT services for children in foster care and children with autism.
November 30, 2017
To date, Congress has not reauthorized funding for the Children’s Health Insurance Program (CHIP), a program that relies entirely on federal dollars to cover low-income children who do not qualify for Medicaid.
If KidsCare (Arizona’s CHIP program) runs out of funding before Congress takes action, AHCCCS will employ a change in the federal funding it uses for children enrolled in Medicaid who have incomes between 100-138% of the Federal Poverty Level. These children (known as the M-CHIP population) are currently funded using CHIP monies, but AHCCCS could instead use Medicaid funding for their coverage. This would free up CHIP dollars and extend the availability of those dollars for KidsCare children for a longer period of time. Each month in which AHCCCS funds coverage for M-CHIP children using Medicaid dollars would fund approximately three months of continued coverage for KidsCare enrollees. In a letter of support, Governor Ducey urged Congress to vote to extend CHIP.
If necessary, this strategy will be employed as a temporary measure to cover the KidsCare population into the first quarter of 2018, with no changes in benefits or enrollment for any Medicaid member.
November 30, 2017
In response to CMS Administrator Seema Verma’s letter to the governors earlier this year that encouraged states to pursue new flexibilities in the administration of their Medicaid programs, AHCCCS has submitted a concept paper to CMS for discussion purposes.
Pursuant to Arizona Revised Statutes Section 36-2903.09 and in response to extensive and thoughtful public comments AHCCCS received regarding SB 1092, this concept paper provides a high level summary of the formal waiver that will be submitted in December.
Additionally, this concept paper proposes a variety of other flexibilities for discussion with the federal government. AHCCCS plans to update these proposals and begin the formal public comment and tribal consultation processes for these proposals in the coming months.
November 20, 2017
The Arizona Health Care Cost Containment System (AHCCCS) has submitted comments in response to the Centers for Medicare and Medicaid Services’ (CMS) Request for Information on the future of the Center for Medicare and Medicaid Innovation (CMMI). Specifically, CMS is seeking feedback on ways to “promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes.”
In it comments, AHCCCS is calling on CMS to (1) leverage its purchasing power to drive delivery system change; and (2) enhance opportunities to improve integrated care for individuals who are eligible for both Medicare and Medicaid.
November 17, 2017
The Arizona Long Term Care annual enrollment choice letters mailed to ALTCS members in November 2017 included incorrect information about available health plan choices. Please disregard this letter. AHCCCS will mail corrected letters the week of November 20. Members will have 60 days from the second mailing date to enroll. Please contact AHCCCS Division of Member Services during business hours with any questions, 8 a.m. to 5 p.m., Monday through Friday. Call (602) 417-7100 from area codes 602, 623, and 480. Call 1-800-334-5283 from area codes 520 and 928. We apologize for any problem this may have caused.
November 15, 2017
The Arizona Health Care Cost Containment System (AHCCCS) announced today that the second year of a two-year, $24 million Federal grant to address the opioid crisis in Arizona will begin in January 2018. Through evidence-based practices, Arizona is using grant funds from the Substance Abuse and Mental Health Services Administration (SAMHSA) to expand access to opioid treatment programs throughout the state.
Under the grant program, the first of five, 24-hour centers for opioid treatment, including two medication-assisted treatment (MAT) centers and three crises centers, opened in October 2017 to address the growing need for access to opioid use disorder treatment.
November 6, 2017
On Nov. 2, AHCCCS released the AHCCCS Complete Care Request for Proposal (RFP) which will integrate physical and behavioral health care contracts under managed care plans for the majority of the 1.9 million AHCCCS members. Integrated delivery will offer a more cohesive health care system for members, incentivize quality health care outcomes with value based purchasing, and leverage health information technology for improved care coordination. Proposals are due on January 25, 2018, and multiple contracts will be awarded on or before March 8, 2018 in the three geographic services areas in the state. Implementation is scheduled for October 1, 2018.
October 26, 2017
Mental Health America (MHA) publishes an annual analysis of the “State of Mental Health in America” and this year, as in last year’s report, the organization ranks Arizona poorly in terms of overall access to behavioral health care – a position that AHCCCS categorically disputes.
September 28, 2017
Although Congress will not take action to reauthorize the Children's Health Insurance Program (CHIP) by the Sept. 30 funding expiration deadline, CMS has advised AHCCCS that redistribution funding will be available to continue the program through at least the next two months. Funding beyond that is subject to further evaluation and may be extended beyond that date. If Congress has taken no action to reauthorize CHIP funding before redistribution funds are exhausted, members enrolled in KidsCare will be notified prior to any program changes.
September 28, 2017
AHCCCS has compiled an analysis of the recent legislation introduced by Senators Lindsey Graham and Bill Cassidy, which would include a variety of changes to the programs established by the Affordable Care Act (ACA).
September 6, 2017
September is National Suicide Prevention Awareness Month and the Arizona Health Care Cost Containment System (AHCCCS) coordinates efforts across several state agencies, organizations, and coalitions to educate citizens that everyone can play a role in preventing suicide in Arizona’s communities.
June 30, 2017
The Arizona Health Care Cost Containment System (AHCCCS) received federal approval to provide American Indian Medical Home (AIMH) services to support approximately 120,000 American Indian/Alaska Native (AI/AN) AHCCCS members who receive health care through the American Indian Health Program.
June 23, 2017
The Arizona Health Care Cost Containment System (AHCCCS) has compiled an analysis of the Better Care Reconciliation Act (BCRA) as of June 22, 2017. Currently, 1.9 million low-income Arizonans are covered under AHCCCS. Approximately 400,000 are included in the main eligibility groups initially affected by the changes included in the BCRA (320,000 in the 0-100% Proposition 204 Childless Adult population and 82,000 in the 100-133% Expansion Adult population). This analysis is based on a preliminary review of the BCRA and is subject to revision. See the full summary below.
June 19, 2017
The 2017 Arizona State Plan to End Suicide is now open for public comment. The annual plan is updated each summer, taking into account the many community coalitions and endeavors across the state.
According to the latest data available, in 2015 there were more than 1340 deaths by suicide in Arizona.
To comment on the 2017 Arizona State Plan to End Suicide please email Kelli Donley Williams. Deadline is August 1, 2017.
June 15, 2017
The Arizona Health Care Cost Containment System (AHCCCS) achieved “exceptional organization” status in the annual employee engagement survey administered across Arizona state government. AHCCCS earned an employee engagement score of 12.4, meaning 12.4 engaged employees to 1 disengaged employee, with 100 percent participation from the agency’s approximately 1000 employees.
June 15, 2017
Beginning June 15 and through the end of July, AHCCCS is accepting applications for the Targeted Investments Program, a strategy to provide financial incentives to eligible AHCCCS providers to develop systems for integrated care. Find the application and detailed application instructions on the Targeted Investments web page.
June 5, 2017
As of June 2, 2017, the Centers for Medicare and Medicaid Services (CMS) has indicated that currently there is only a path forward for an IMD waiver for individuals with substance use disorder needs, as part of a comprehensive state substance use disorder (SUD) strategy. AHCCCS will move forward with the submitting such comprehensive strategy, and will comply with the IMD provisions of the managed care regulations for individuals with non-SUD behavioral health conditions.
In the upcoming weeks, AHCCCS will revisit strategies identified by MCOs and providers to continue discussions related to compliance with this regulation.
May 23, 2017
AHCCCS, the Arizona Health Care Cost Containment System, has been honored with a 2017 When Work Works Award for exemplary workplace practices. With more than 1000 employees, AHCCCS is the largest of the 10 organizations in Arizona – and the only state government agency – to receive the 2017 national recognition. This is AHCCCS’ sixth When Work Works award in the last seven years.
May 24, 2017
AHCCCS, the Arizona Health Care Cost Containment System, recently received Gold level recognition from the Healthy Arizona Worksite Program for excellence in worksite wellness.
April 26, 2017
The Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) awarded a grant to Arizona of $24,343,406 over a two-year period in an effort to combat opioid use disorder (OUD) and opioid-related deaths. The funding was awarded in a non-competitive, formulary grant based on prevalence and need.
April 12, 2017
Today, AHCCCS submitted to Centers for Medicare & Medicaid Services (CMS) a request for a waiver from restrictions on federal funding for services provided to Medicaid beneficiaries aged 21-64 who receive inpatient services in an Institution for Mental Disease, regardless of delivery system. With this approval, AHCCCS would maintain and enhance beneficiary access to behavioral health services.
March 17, 2017
The Arizona Health Care Cost Containment System (AHCCCS) has compiled an analysis of the American Health Care Act (AHCA) as of March 15, 2017. Currently, 1.9 million low-income Arizonans are covered under AHCCCS. Approximately 400,000 are included in the main eligibility groups initially affected by the changes included in the AHCA: 316,000 in the 0-100% Proposition 204 Childless Adult population and 81,000 in the 100-133% Expansion Adult population. See the full summary below.
March 07, 2017
The National Association of Medicaid Directors (NAMD) has released the following analysis of the American Health Care Act (AHCA), legislation unveiled in the House on March 6, 2017, which would make changes to the Affordable Care Act and convert Medicaid financing into a per-capita system. See the analysis below.
March 03, 2017
The Arizona Health Care Cost Containment System (AHCCCS) announces the award of contracts to three Managed Care Organizations to provide health care services to Arizonans who qualify for Arizona Long Term Care System (ALTCS). Banner-University Family Care, Southwest Catholic Health Network Corporation dba Mercy Care Plan, and UnitedHealthcare Community Plan have been selected to serve the three Geographic Service Areas (GSA) in Arizona. These health plans will provide services to over 26,000 AHCCCS members who are elderly (65 and over), blind, or disabled and at risk of institutionalization.
Contracts, which become effective October 01, 2017, are awarded for up to seven years, for service in the following Geographic Service Areas:
February 07, 2017
AHCCCS invites public comment on this request for information regarding integrated health plan contractors. AHCCCS believes that health care delivery system design is essential to improving outcomes for our members while assuring the care provided is cost effective and easy for members and families to access. Integrated health plan contractors able to address the whole health needs of our state’s Medicaid population are key to reducing the fragmentation that exists in our health care system and improving service delivery to AHCCCS members.
As part of the contracting cycle which begins with Contract Year 2019 (CYE 19), starting on October 01, 2018, AHCCCS is proposing to offer fully integrated contracts to manage behavioral health (including mental health and substance use disorder) and physical health services to children (including children with CRS conditions) and adult AHCCCS members not determined to have SMI. AHCCCS is also proposing to preserve the RBHAs as a choice option and provide a mechanism for affiliated contractors to hold a single contract with AHCCCS for non-ALTCS members.
AHCCCS is hosting community meetings across the state to gather feedback from stakeholders including members and their families, advocates and providers, to support and inform its efforts to develop integrated health plan contracts. Please RSVP to Sherri.Moncayo@azahcccs.gov as session capacity is limited.
|Community Forum Location||Dates|
701 E. Jefferson St, Phoenix, AZ 85034
|Date: February 10, 2017
Location: Phoenix, Arizona
Time: 2:30 pm – 4:00 pm
Pima County Library
Lower Level 1 Meeting Room
101 N. Stone Ave. Tucson, AZ 85701
|Date: February 14, 2017
Location: Tucson, Arizona
Time: 1:30 pm – 3:00 pm
Sedona Room 40
4215 Arts Village Drive Sedona, AZ 86336
|Date: February 16, 2017
Location: Sedona, Arizona
Time: 9:30 am – 11:00 am
1702 N Fourth St, Flagstaff, AZ 86004
|Date: February 16, 2017
Location: Flagstaff, Arizona
Time: 1:00 pm – 2:30 pm
Please see below for the integrated contractors RFI presentation slides:
Response to open RFI YH17-0108 for Integrated Contractors – Affiliated Organization Requirement is due by June 30, 2017. Find more information on the Open Contracts page.
The original RFI (YH17-0059) which closed Feb. 27 and can be found on the Closed Contracts page.
January 27, 2017
On January 25, 2017, AHCCCS provided the Arizona Chamber of Commerce with a program update. For more information, please visit the link below.
January 18, 2017
The Centers for Medicare and Medicaid Services (CMS) has approved Arizona's request to begin a Targeted Investments Program that will make almost $300 million available over five years to Arizona providers who assist the State in promoting the integration of physical and behavioral health care, increasing efficiencies in care delivery, and improving health outcomes.
As part of this larger integration effort, the Program will have a specific project focused on assisting those AHCCCS members who have transitioned into the community from criminal justice facilities. Connecting justice-involved members to appropriate acute and behavioral health care services upon their release improves their health outcomes, helps them to reintegrate into the community, and reduces recidivism.
This Targeted Investment will support the state's ongoing efforts to integrate the delivery system for AHCCCS members.
The approval letter from CMS can be viewed here.
December 14, 2016
AHCCCS has posted the notice of public information describing the proposed changes for the Fee-For-Service (FFS) rates, and capitation rate adjustments, to be effective beginning January 01, 2017. These adjustments are to address the increased labor costs resulting from the Arizona minimum wage increase and employee benefit provisions mandated by Proposition 206. For more information, please visit the link below.
December 01, 2016
On November 28, 2016, AHCCCS provided the Greater Phoenix Chamber of Commerce with a program update. For more information, please visit the link below.
November 18, 2016
On July 05, 2016, a new Federal regulation from the Centers for Medicare and Medicaid Services (CMS) became effective which limits Federal funding for services to persons in IMDs who are aged 21-64. Federal Rule 42 C.F.R. 438.6(e) prohibits Federal Medicaid funding to Managed Care Organizations when members aged 21-64 are in IMDs for more than 15 days during a calendar month. AHCCCS understands the significant impact of this change and is collaborating with Managed Care Organizations to implement these changes. Managed Care Organizations are also working with providers to implement strategies which maximize continuity of care for members.
October 26, 2016
On October 24, 2016, Governor Ducey signed an executive order directing the Arizona Health Care Cost Containment System (AHCCCS) and the Arizona Department of Administration (ADOA) to adopt any necessary policies and rules to limit the initial fill of any prescription opioid to no more than seven days for adults. For minors, the seven day limitation applies to all initial and subsequent opioid prescriptions, except in the case of cancer, other chronic disease, or traumatic injury. For more information on the executive order, please see the link below.
September 30, 2016
The Centers for Medicare and Medicaid Services (CMS) approved Arizona’s request to modernize its Medicaid program and continue many of the existing authorities that allows AHCCCS to maintain its unique and successful managed care model, use home and community based services for members with long term care needs and other innovations that make AHCCCS one of the most cost effective Medicaid programs in the nation. More information including the approved package can be found on the links below.
October 13, 2016
Every year since 2006, United Cerebral Palsy (UCP) produces The Case for Inclusion, an annual ranking of how well State Medicaid programs serve Americans with intellectual and developmental disabilities (ID/DD) and their families.
States were ranked based on four key aspects, for which Arizona was ranked #1 overall: promoting independence, promoting productivity, keeping families together and reaching those in need, and tracking health, safety, and quality of life.
September 29, 2016
October is Domestic Violence Awareness Month. On October 3rd, Governor Ducey will light the State Capitol purple as a symbol of Arizona's dedication to reduce the number of people suffering domestic abuse. Arizonans are invited to join Governor Ducey by lighting their own homes purple for the month of October.
July 26, 2016
Applications for KidsCare are being accepted today for coverage that will begin September 01, 2016, thanks to Senate Bill 1457 signed by Governor Doug Ducey. KidsCare is Arizona’s version of the federally created Children’s Health Insurance Program (CHIP), providing health care coverage to children in households between 133% and 200% of the Federal Poverty Limit (FPL).
May 18, 2016
Applications for KidsCare will be accepted beginning July 26, 2016 for coverage that will begin September 01, 2016. Applications received before July 26 will be denied until the recently signed legislation becomes effective, which also allows time for needed changes within the State’s eligibility system, Health-e-Arizona Plus (HEAplus), in order to accept the KidsCare applications.
June 30, 2016
June 30 marks Arizona’s exit to a decades old lawsuit known as Arnold v. Sarn. Arnold was a class action lawsuit filed in 1981 against the State of Arizona alleging a failure to provide a comprehensive community mental health system as required by statute.
June 16, 2016
Maricopa County’s Health Care Integration program has been awarded the National Association of Counties Achievement Award in Health. Maricopa County was honored for the “Medicaid Application Services for Substance Using Jail Inmates” program which provides health care education and AHCCCS application assistance to substance using inmates. Since November 2015, this program has resulted in over 125 participants transitioned into AHCCCS immediately upon release from jail. AHCCCS is proud to have partnered with Maricopa County on this program and will continue to work towards simplifying the process of transitioning members from the justice system directly into care. For more information on AHCCCS Justice Initiatives visit the webpage linked below.
June 06, 2016
Arizona is one of three states leading the nation in connecting justice-involved individuals to health care services. Reaching incarcerated individuals to connect them to health care coverage and treatment services upon release can improve health outcomes and increase their chances at successful reintegration into the community. This can also lead to decreased recidivism. AHCCCS has been working with the counties, courts, and other state agencies to change approaches to assisting this population. Connecting the Justice-Involved Population to Medicaid Coverage and Care
May 31, 2016
AHCCCS has been honored with a 2016 When Work Works Award for its use of effective workplace strategies to increase business and employee success. This prestigious award, part of the national When Work Works project administered by the Families and Work Institute (FWI) and the Society for Human Resource Management (SHRM) recognizes employers of all sizes and types in Arizona and across the country. Read more...
May 27, 2016
This report is an update to a previously published report analyzing psychotropic prescribing among children in Arizona’s foster care system. The percentage of children in foster care receiving psychotropic medications decreased by 26% from 2008 to 2014, from 20.3% to 14.9% respectively. The percentage of children in foster care receiving antipsychotic medication decreased by 43%, from 10.9% to 6.2%. The percentage of children receiving a prescription in each of the other categories of medication reviewed also declined, except for the percentage of children receiving ADHD medication, which remained the same. The 2013 data shows a decrease from 2008 data in the overall ratio of the rate of prescribing, with children in foster care 4.1 times more likely to be on psychotropic medication compared to the general Medicaid child population. Only 1 in 15 children in Medicaid that are not in foster care use behavioral health services as compared to 2 in 3 foster care children. This report will be updated on an ongoing basis. Future reports will also include a comparison of prescribing trends between the foster child population and the Medicaid child population that is utilizing behavioral health services.
May 26, 2016
It is common knowledge that employment for individuals with psychiatric disabilities, among many other things, alleviates poverty, reduces hospitalizations, and improves quality of life. Evidence based practices in psychiatric rehabilitation demonstrate that employment services should be provided in a variety of formats, including individual and group. AHCCCS recently approved the addition of an “HQ” group modifier to the pre and post-employment codes H2027 (Psychoeducational Services) and H2025 (Ongoing Support to Maintain Employment) in the Behavioral Health Covered Services Guide. Correspondence was sent to the Regional Behavioral Health Authorities (RBHAs) on 05/18/2016 notifying them of the change.
May 26, 2016
AHCCCS and Rehabilitation Services Administration/Vocational Rehabilitation (RSA/VR) will work together to provide specialized vocational services through an Intergovernmental Agreement (IGA) for individuals determined to have a Serious Mental Illness (SMI). The purpose of the IGA is to increase the number of successfully employed people with psychiatric disabilities. The previous IGA was between the Arizona Department of Health Services/Division of Behavioral Health Services and RSA/VR. AHCCCS will provide state funding that RSA/VR can match with federal funds at a 4:1 ratio. For FY 2017, understanding how important employment is to an individual’s recovery, AHCCCS has decided to increase the amount provided to RSA/VR by an additional $500,000, bringing in approximately $2.5M more funding to support individuals determined to have SMI to become employed.
May 25, 2016
AHCCCS achieved an overall employee engagement score of 9 engaged employees to 1 disengaged employee, according to a recent employee survey administered across state government. Employee engagement captures the degree to which employees are enthusiastic and committed to their workplace. World class organizations have a 9 to 1 engagement, according to Gallup. Read more...
April 18, 2016
On April 11, 2016, AHCCCS submitted comments to SAMHSA regarding its proposed rules to update the regulations governing privacy and security of substance use disorder records.
April 01, 2016
AHCCCS is part of a growing partnership with Maricopa County, DES and others to focus on health care and substance abuse treatment for individuals who have been involved in the justice system. To help stem the tide of incarcerations for persons with behavioral health needs, AHCCCS has focused its work with county governments, DES and others to connect individuals to health care to reduce the number of people returning to jail. More information about these efforts, including recent news coverage can be found on the Justice System Initaitives page.
March 24, 2016
Each RBHA has established a designated point of contact for foster families and others involved in the DCS system. Coleen Neal, a foster and adoptive parent for 9 years, used this special line in reaching out to Mercy Maricopa for help for her adopted son. “I felt like I had an advocate from Day 1. I feel hopeful that he’s getting the correct care that he’s needed for so long. I finally do feel hopeful for him.”
March 24, 2016
On March 24, 2016, Governor Ducey signs crucial legislation for Arizona foster children. More information can be found in the links below.
March 14, 2016
AHCCCS and DCS clarify that foster caregivers have the authority to consent to behavioral health services on behalf of children in their care.
February 29, 2016 (Originally posted: January 25, 2016)
Behavioral Health Is A Priority in Arizona February 29, 2016 (Originally posted: January 25, 2016) The NAMI State Mental Health Legislation 2015 Trends included inaccurate information about Arizona’s focus on behavioral health that has been corrected since a joint ADHS/AHCCCS letter was sent. Congratulations and thanks to NAMI for their willingness to review Arizona’s information and make corrections where needed. Arizonans across the State have worked tirelessly to build a community-based behavioral health system that supports individuals in reaching recovery and resiliency. The letter and other links to some of Arizona’s initiatives to streamline and improve care coordination, member satisfaction and health care outcomes can be found in the links below :
November 19, 2015
AHCCCS is providing the anticipated procurement timeline with stakeholder forum information for the YH18-0001 Request for Proposal for the Elderly and Physical Disability Program (EPD) for members of the Arizona Long Term Care System (ALTCS) program. Information is accessible at the following link: YH18-0001 - Arizona Long Term Care E/PD Bidders' Library
May 23, 2015
A new analysis provided by Moody’s Investors Services indicates Arizona has controlled Medicaid spending on long-term care for the 65-and-up population. According to the analysis, the national average for long-term care spending increased an average of 6.5 percent a year from 1999-2009, while Arizona contained its costs at a rate below 4 percent. For more information, please see the link below.