AHCCCS News & Updates 

Community Forums for SB 1092 Legislative Directive Waiver Proposal are open for registration.

AHCCCS News & Updates

AHCCCS Recognized for Innovative and Effective Workplace Practices

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.

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Healthy Arizona Worksites Program Gives AHCCCS Gold Award

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.

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Arizona Awarded $24 million in Federal Grant Funding to Combat Opioid Use Disorder

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.

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IMD Waiver Request Submitted

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.

Read more about the IMD waiver amendment request...

Summary of AHCA Impacts

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.

Summary of AHCA Impacts

NAMD Releases Analysis of American Health Care Act

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.

NAMD Rapid Analysis_American Health Care Act

Arizona Health Care Cost Containment System (AHCCCS) Announces Award of Contracts for Arizona Long Term Care System (ALTCS) Program

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:

  • Central GSA (Maricopa, Gila and Pinal Counties)
    • Banner-University Family Care
    • Southwest Catholic Health Network Corporation dba Mercy Care Plan
    • UnitedHealthcare Community Plan
  • South GSA (Cochise, Graham, Greenlee, La Paz, Pima, Santa Cruz, and Yuma Counties)
    • Banner-University Family Care
    • Southwest Catholic Health Network Corporation dba Mercy Care Plan (Pima County only)
  • North GSA (Mohave, Coconino, Apache, Navajo, and Yavapai Counties)
    • UnitedHealthcare Community Plan

Read More...

Community Forums on Integrated Contractors RFI

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
Phoenix
AHCCCS—Gold Room
701 E. Jefferson St, Phoenix, AZ 85034
Date: February 10, 2017
Location: Phoenix, Arizona
Time: 2:30 pm – 4:00 pm
Tucson
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
Yavapai College
Sedona Room 40
4215 Arts Village Drive Sedona, AZ 86336
Date: February 16, 2017
Location: Sedona, Arizona
Time: 9:30 am – 11:00 am
Flagstaff
Flagstaff AquaPlex
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:

More information regarding the integrated contractors RFI (YH17-0059) can be found here: https://www.azahcccs.gov/Resources/OversightOfHealthPlans/SolicitationsAndContracts/open.html

AHCCCS Update to the Arizona Chamber of Commerce – Health Care Committee

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.

Arizona Chamber of Commerce Presentation

CMS Approves AHCCCS Targeted Investments Program

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.

Proposition 206 - Rate and Capitation Adjustment

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.

Proposition 206 Notice of Public Information

AHCCCS Update to the Greater Phoenix Chamber of Commerce

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.

Greater Phoenix Chamber of Commerce Presentation

15 Day Limitation Effective July 5, 2016 for Institutions for Mental Disease (IMD)

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. Below is additional information about this new regulation.

The new Federal regulation for IMDs:

  • Is limited to adults aged 21-64.
  • Eliminates the existing Federal authority which allows AHCCCS to utilize IMDs with no limits (referred to as the “in lieu” option).
  • Allows coverage for stays in an IMD so long as the stay is no longer than 15 days during a calendar month.
  • Requires AHCCCS to recoup the entire monthly payment made by AHCCCS to the member’s Managed Care Organization responsible for all care of the member when the member’s stay in the IMD is longer than 15 days during the month.
    • The recoupment of the entire monthly payment to the Managed Care Organization is required based on the member’s continued placement in the IMD after day 15 during a calendar month regardless of whether or not the Managed Care Organization pays the IMD.

What is an IMD?

  • Federal guidance provides that an IMD is a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged in providing diagnosis, treatment or care of persons with mental diseases, including medical attention, nursing care and related services. An institution for mental diseases is determined by its overall character as a facility that is established and maintained primarily for the care and treatment of individuals with mental diseases even if it is not licensed as an IMD. An institution for Individuals with Intellectual Disabilities is not an institution for mental diseases.
  • Federal regulation defines an “Institution” as “an establishment that furnishes (in single or multiple facilities) food, shelter, and some treatment or services to four or more persons unrelated to the proprietor.”
  • AHCCCS considers the following provider types to be IMDs at this time based on the federal regulation. This list is subject to change:
    • B1-RESIDENTIAL TREATMENT CTR-SECURE (17+BEDS)
    • B3-RESIDENTIAL TREATMENT CENTER-NON-SECURE
    • B6-SUBACUTE FACILITY (17+BEDS)
    • 71-PSYCHIATRIC HOSPITAL

Governor Ducey's Executive Order for Prescription Opioids

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.

Executive Order 2016-06 - Prescription Opioid; Initial Fill Limitation

Federal Government Approves Governor Ducey’s AHCCCS CARE Program: Promoting Choice, Accountability, Responsibility, Engagement (CARE)

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.

The Case for Inclusion – Arizona Ranked #1

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.

The Case for Inclusion: United Cerebral Palsy’s 2016 Report

Governor Ducey Lights Arizona Purple

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.

Lighting Arizona Purple: Domestic Violence Awareness Event

KidsCare Accepting Applications Today Coverage Effective September 01, 2016

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).

KidsCare News Release

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.

KidsCare News Release

Arizona’s Community-Based Behavioral Health System Leads the Nation: June 30, 2016 Marks Achievement of Benchmark In Stipulation That Ended Decades Old Lawsuit

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.

Arnold v. Sarn press release

Maricopa County wins 2016 NACo Achievement Award in Health

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.

Justice System Initiatives

The Link Between Health Care and the Justice System

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

AHCCCS Recognized For Exemplary Workplace Practices 2016 When Work Works Award Recipient

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...

Behavioral Health Needs of Children involved with the Department of Child Safety: Psychotropic Prescribing Update

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.

Psychotropic Prescribing Update Report

HQ Modifier

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.

Memo regarding HQ Modifier

Additional IGA Funding

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.

AHCCCS Achieves World Class Employee Engagement Levels

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...

Arizona Comments to Proposed Rules: Confidentiality of Substance Use Disorder Patient Records

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.

AZ Comments 04/11/2016

Justice System Initiatives

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.

Justice System Initiatives

FOSTER PARENTS: DO NOT WAIT! CALL YOUR DESIGNATED POINT OF CONTACT IF YOU NEED BEHAVIORAL HEALTH SERVICES

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.”

Call your point of contact today

Governor Doug Ducey Signs Crucial Legislation For Arizona Foster Children

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.

Governor Ducey Signs Crucial Legislation for Arizona Foster Children
Statement from AHCCCS Director on Signing of Jacob’s Law
Letter from the Arizona Association of Health Plans

Clarification from AHCCCS and DCS Directors re Consent for BH Services

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.

AHCCCS DCS Letter 03/14/2016

Behavioral Health Is A Priority in Arizona

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 :

NAMI Revised Report
ADHS and AHCCCS Letter to NAMI
AHCCCS Initiatives
Recovery Works Newsletter

ALTCS EPD YH18-0001 Request for Proposal Pre-Release Information

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

Viewpoints: Arizona leads the nation in providing care for those needing skilled health services

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.

Moody’s Investor Services


Home is where the health is

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