This article is reprinted from Raising Special Kids Fall 2018 Connecting Newsletter
Changes to AHCCCS and DDD
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Tell me more…
Families who receive health coverage through Arizona Health Care Cost Containment System (AHCCCS) may have heard about changes set to begin October 1, 2018. The most important thing to know is that there is no change to eligibility criteria or services. AHCCCS members will still have access to the same AHCCCS covered services as they do with current health plans and Regional Behavioral
Health Authorities (RBHAs). The changes involve which agencies pay for the services people receive. These changes will result in comprehensive managed care for the whole person rather than acute care (medical) services and behavioral health services offered by different providers. AHCCCS is referring to these integrated plans as AHCCCS Complete Care or ACC.
WHAT WILL CHANGE WITH ACC?
In the past, AHCCCS acute care (physical health) services and behavioral health services were provided by different organizations. Beginning October 1, 2018, agencies will be required to provide both physical care and behavioral health services. Members will benefit by only having one health plan that will help coordinate care for better outcomes and improved whole health for the member.
WHO WILL BE AFFECTED BY THIS CHANGE?
– Most adults and children on AHCCCS will be enrolled with ACC Plans beginning October 1, 2018 including members currently enrolled in CRS.
– ACC will not affect members in the Arizona Long Term Care System (ALTCS), including those enrolled with DDD. There are a few exceptions for members who are also eligible for CRS services. (For more information about members enrolled with CRS, see http://www.azahcccs.gov/AHCCCS/Initiatives/AHCCCSCompleteCare/CRS/.)
– ACC will not affect members determined to have a Serious Mental Illness (SMI).
– With the exception of foster care children currently enrolled in CRS, ACC will not affect most children in foster care enrolled in the Comprehensive Medical and Dental Program (CMDP).
WILL I BE ASSIGNED TO AN ACC PLAN OR WILL I HAVE CHOICE OF AVAILABLE ACC PLANS?
Members in an acute health plan that will also be an ACC Plan in their service area will stay with their current health plan. These members will have choice of other ACC Plans during their annual enrollment choice month. Members in a health plan that will not be an ACC Plan in their service area have been assigned an ACC Plan. AHCCCS sent letters to tell members their assigned ACC Plan in June 2018. Members were allowed to choose a different ACC Plan in their service area until July 31, 2018. Some members in an acute plan that will also be an ACC Plan (not affiliated with their assigned RBHA) in their service area, who received behavioral health services through the RBHA in 2017, were given a one-time choice to move to an ACC Plan that is affiliated with the RBHA in their service area. These members were notified in late June their choice during the month of July 2018. All members will have the opportunity to select a new ACC plan during their enrollment choice month.
WHAT WILL REGIONAL BEHAVIORAL HEALTH AUTHORITIES (RBHAs) CONTINUE TO PROVIDE?
RBHAs will no longer serve most adults and children. This is because behavioral health services will be provided by the ACC Plan. RBHAs
will continue to serve:
– Foster children enrolled in CMDP, including those CMDP members who have a CRS condition.
– Members enrolled with DDD.
– Individuals determined to have a SMI.
There will be no changes to RBHA services for members they continue to serve. RBHAs will also continue to provide crisis, grant funded and state‐only funded services.
ACC FAQs FOR MEMBERS WITH CRS CONDITIONS
Q. Will my covered services change under ACC?
A. Under ACC Plans, members will have access to the same array of covered services as they do under their current health plan.
Q. Will CRS member have to change health plans?
A. Currently, most members with CRS conditions are enrolled with UnitedHealthcare Community Plan. Effective October 1, 2018, CRS members will be enrolled with an ACC plan. Under the ACC Plan, members will have access to the same array of covered services as they do under their current health plan.
Q. Will my foster child’s Comprehensive Medical Dental Program (CMDP) coverage change?
A. Children in foster care who have CRS conditions will receive all physical health services, including services for their CRS condition, from CMDP. Like all children in foster care, they will transition to the RBHA in their area for behavioral health service.
Q. If my child is enrolled in the American Indian Health Program, how will she/he receive CRS services?
A. The AIHP will provide physical and behavioral health services including CRS services to children enrolled in that program.
Q. How will members with CRS qualifying conditions who are enrolled in DDD/ALTCS receive services?
A. Members with developmental disabilities and CRS conditions who are enrolled in Arizona Long Term Care will remain with UnitedHealthcare Community Plan for physical health services related to their CRS conditions and for all behavioral health services. They will use their assigned DDD health plan for all non-CRS related physical health services.
ACC FAQs FOR AMERICAN INDIAN MEMBERS
Q. What is the American Indian Health Program and who does it serve?
A. The AIHP is currently a program administered by AHCCCS for eligible American Indians. AIHP reimburses for physical and behavioral health services when provided by or through the Indian Health Services or tribally owned or operated organizations. AIHP also pays for physical health services with other medical facilities such as a local hospital.
Q. What changes are happening for AIHP and when will they be effective?
A. Currently, most members enrolled in AIHP are also enrolled with a RBHA or TRBHA for behavioral health services. On October 1, 2018, AIHP will pay for and handle physical and behavioral health services for most eligible American Indian adults and children. AIHP will also pay for services related to a CRS condition. Members will still be allowed to choose AIHP and a TRBHA (when available) for behavioral health services.
Q. Will American Indian members still be allowed to change enrollment?
A. American Indian members can still choose to change enrollment between AIHP (with or without TRBHA enrollment) or the ACC plan at any time.
Q. Will there be changes for American Indian members who are determined to be seriously mentally ill?
A. American Indian members who are determined to be SMI will receive services from the RBHA but can also still choose AIHP for physical health services. Those who currently receive services with TRBHA, there will be no change in service delivery or choice.
For More Information on AHCCCS Complete Care, visit: