AHCCCS Benefit Changes

Due to implementation requirements, benefit changes will be effective October 1, 2010. Information and attachments on this page have been updated.

Note: Information provided in PDF files, unless otherwise noted.

Overview

In response to significant fiscal challenges facing the State and substantial recent growth in the Medicaid population, AHCCCS will implement several changes to the adult benefit package, effective October 1, 2010. The benefits being eliminated or limited are all considered optional services under federal law and therefore, AHCCCS is not required to provide them. More information about these upcoming changes is provided below. Continue to check this page for updates as they become available. Information available at this time is outlined in the Benefit Fact Sheet below.

Benefit Fact Sheet - 6/1/10 [38KB]

Legislation

The FY 2010 enacted budget directs AHCCCS to eliminate various medical and health services for adults.

HB 2010 (See page 21 of this PDF file, which is page 20 of the bill.)

 AHCCCS Memos to Providers

AHCCCS will publish memoranda regarding additional information as it becomes available.

• Memo, Benefit Changes - 8/2/2010 [420KB]
• Memo, Podiatric Services - 4/5/10 [24KB]

Regulatory Updates

When available, proposed changes to the State Plan and Arizona Administrative Code will be posted here.

Waiver Amendment

• Non Emergency Medical Transportation - Submitted 8/13/2010 [43KB]

Medicaid State Plan Amendments (SPAs)

• SPA 10-006: Benefit Changes - Approved 8/11/10 [502KB]

Final Rules filed with AZ Secretary of State

• R9-22-101, R9-22-201, R9-22-202, R9-22-203, R9-22-205, R9-22-206, R9-22-207, R9-22-212, R9-22-215: Service Limitations/Exclusions [242KB]
• R9-28-206: Arizona Long Term Care System (ALTCS) [137KB]
• R9-22-206: Exclusion of Pancreas-only Transplants [31KB]

 Medical Policy Updates

The AHCCCS Medical Policy Manual (AMPM) will be amended to reflect the changes in the adult benefit package, effective 10/1/2010. Conforming changes to other sections of the AMPM will be published prior to 10/1/2010. Refer to the following files for updates to specific Medical Policy changes:

• 310-D, Dental Service for Members 21 Years and Older
• 310-H, Health Risk Assessment and Screening Tests
• 310-P, Medical Supplies, DME, and Orthotic/Prosthetic Devices
• 310-U, Foot and Ankle Services
• 310-X, Rehabilitation Services (OT, PT, and Speech)
• 310-DD, Covered Transplants and Immunosuppressant Medications [1.9MB]
• 320-D, Reserved (formerly Cochlear Implantation) [545KB]
• 320-J, High Frequency Chest Wall Oscillation [587KB]

The current version of the AMPM, without these impending changes, can be viewed by following the link below:

AHCCCS Medical Policy Manual (current version)

FAQs

The Frequently Asked Questions (FAQs) respond to inquiries about the benefit changes. As AHCCCS continues its review, it will update the FAQs. If you do not find a response to your question, please email: LegislativeBenefitChange@azahcccs.gov. Members should contact their health plans for additional information.

Benefit Changes FAQs - 6/1/10 [37KB]