AHCCCS News & Updates 

On Sunday 01/21/2018 from 4:00 AM to 12:00 PM (noon), some of AHCCCS services will not be available due to scheduled maintenance.

AHCCCS News & Updates


Arizona Awarded $20 Million to Combat the Opioid Epidemic

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.”

Read more...

ACC Message from the Director

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.

AHCCCS Complete Care Will Integrate Health Care Services Beginning October 1

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.

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Medication Assisted Treatment Symposiums To Focus on Opioid Use Disorder Treatment Strategies

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.

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Monthly Behavioral Health Enrolled & Served Report

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.

AHCCCS Differential Adjusted Payment (DAP) Decision Posted

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.

Find more information on the Public Notices page under Rates & Supplemental Payment, or see Differential Adjusted Payment Decisions.

AHCCCS Earns Platinum Award from the Healthy Arizona Worksites Program

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.

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May is Mental Health Awareness Month in Arizona

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.

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New Treatment Options for Opioid Misuse, Abuse or Dependence

April 23, 2018
The opioid epidemic is a public health emergency in Arizona. From prescription opioid overuse to abuse of illegally produced opioids like heroin and fentanyl, the epidemic is damaging families across all demographics in our state.

It’s likely you know someone who is affected by opioid use disorder. AHCCCS, as the administrator of a Federal Substance Abuse and Mental Health Services Administration (SAMHSA) grant, has increased treatment options to include 24/7 access to Opioid Treatment Programs.

Read more...

1115 Waiver Request Seeks to Limit Retroactive Coverage for New Members

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.

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AHCCCS Awards Integrated Health Care Contracts to Seven Managed Care Organizations

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).

Read more...

Final Analysis of CMDP Integrated Health Plan Capacity Released

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.

Read Mercer’s Final Analysis

Targeted Investments Applicants Selected

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.

See the full of list participants on the Targeted Investments List of Participants webpage.

New Arizona Opioid Epidemic Act To Expand Treatment and Prevention Options

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.

Read more...

CHIP Funding Reauthorized for Six Years

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.

Prior Quarter Coverage Waiver Request Open for Public Comment

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.

Independent Analysis of CMDP Integrated Health Plan Capacity Released

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.

Read the Mercer CMDP Analysis...

“AHCCCS Works” 1115 Waiver Amendment Request Submitted

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.

Read more...

Jami Snyder Joins State Medicaid Agency as Deputy Director

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.

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Behavioral Health Funding By Initiative

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.

Read more...

No Changes to KidsCare Program Planned

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.

Flexibilities Concept Paper Submitted to CMS

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.

Flexibilities Concept Paper

AHCCCS Responds to CMS Request for Information Regarding CMMI

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.

AHCCCS’ full response to CMS CMMI.

ALTCS Annual Enrollment Choice Letters To Be Resent

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.

Access to Opioid Treatment Programs to Expand in Arizona

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.

Read more...

AHCCCS Complete Care RFP Released

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.

Read more...

Crisis Services, Peer Support Systems Underscore Arizona’s Behavioral Health Services

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.

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CMS to Allocate Redistributed Funds to Continue KidsCare Program

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.

Summary of Graham-Cassidy Impacts

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).

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During September, State Agencies and Organizations Call Attention to Suicide Prevention

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.

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New Program Will Enhance Health Care Coordination for American Indian AHCCCS Members

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.

Read more...

Summary of BCRA Impacts

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.

Summary of BCRA Impacts

State Plan to End Suicide Open for Public Comment

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.

AHCCCS Earns “Exceptional Organization” Status in 2017 Employee Engagement Survey

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.

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Targeted Investments Program Accepting Applications

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.

CMS Responds to Request to Waive 15 Day Institutions for Mental Disease (IMD) Limitation

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.

Read more about the IMD waiver request...

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.

Read more...

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:

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.

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.

Read more about the IMD Federal regulations...

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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