Effective October 1, 2018, the American Indian Health Program (AIHP) will be responsible for provision of integrated care for American Indian adult and child members who select AIHP and who have not been determined to be seriously mentally ill. Integrated care services include both physical and behavioral health services, including services related to a Children’s Rehabilitative Service’s condition.
In addition to these changes to AIHP, AHCCCS will be making changes to the Acute and CRS managed care program to contract with integrated health plans delivering both physical and behavioral health services to be named AHCCCS Complete Care. American Indian members who have not been determined to be seriously mentally ill will have the choice of integrated care through either AIHP or through AHCCCS Complete Care Contractors effective October 1, 2018. When served by AIHP, the member also has the choice of a TRBHA (when available) for provision of behavioral health services.
As currently applies, American Indian members who are determined to be seriously mentally ill will continue to be assigned to the RBHA for all services but will also have a choice of keeping the RBHA or selecting AIHP for physical health services and the RBHA or TRBHA (when available) for provision of behavioral health services. American Indian members determined to be seriously mentally ill will continue to be permitted to opt out of the integrated RBHA as specified in ACOM Policy 442 to be served by the AHCCCS Complete Care Contractor for physical health services and the RBHA or TRBHA (when available) for behavioral health services.
American Indian members will continue to be allowed to change enrollment between AIHP or the AHCCCS Complete Care Contractor at any time. However, a member can still only change from one Integrated Contractor to another once a year.
American Indian members, title XIX and XXI, on- or off-reservation, eligible to receive services, may continue to choose to receive services at any time from an American Indian Health Facility including an Indian Health Service (IHS) Facility, a Tribally-Operated 638 Health Program, and an Urban Indian Health Program.
To read more about the integration stakeholder meetings, including the tribal specific presentations, please see this page.