AHCCCS Announces Differential Adjusted Payments (DAP) to Qualifying Providers
The Arizona Health Care Cost Containment System (AHCCCS) announces the qualified providers who have been selected to receive Differential Adjusted Payments (DAP) in Contract Year 2024.
The qualifying providers are listed by provider type and DAP, and are identified by name and NPI. The posted DAP rates will be effective for dates of service beginning October 1, 2023, through September 30, 2024.
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AHCCCS To Set Rate Applied Behavior Analysis Services
The public comment period on updates to the annual fee schedule rates, including a proposal to establish set rate codes for Applied Behavior Analysis (ABA) services has closed, and AHCCCS is grateful for the public input from providers and families who use these services.
The agency will review all comments received and use that feedback to inform the rate setting policy decision that proposes to change the ABA payment methodology from the current “by report” method to a set rate. Changing this payment methodology minimizes the possibility of fraudulent Medicaid claims billing against these codes and further strengthens the agency’s ability to eliminate fraudulent providers from its system. On Oct. 1, 2022, and May 1, 2023, AHCCCS made similar changes to other “by report” rate codes.
The set rates proposed by AHCCCS are based on extensive analysis of rates paid by other states and insurers, and were developed using data from the Bureau of Labor Statistics to establish reasonable cost estimates for providers completing these services.
The rate changes will only apply to providers who bill the AHCCCS Fee for Service Program, the American Indian Health Program (AIHP). Providers billing contracted Managed Care Organizations (MCOs) are able to negotiate their own rates with the MCOs.
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More Than 80 Percent of August Renewals Result in Continued Medicaid Coverage
AHCCCS released its fourth monthly Medicaid renewal data dashboard detailing progress since the regular renewal process began on April 1, 2023.
Of the renewals initiated in August, more than 80% of members maintained their Medicaid coverage and 73% of those renewals were automatically determined to be eligible.
The automatic process, known as ex parte, refers to an individual being determined eligible without the need for the member to provide additional information or proof.
AHCCCS determines ex parte on the individual, not household, level, in compliance with CMS regulations.
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AHCCCS Connect Launched to Help Members Apply for and Renew Medicaid Coverage |
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AHCCCS recently launched AHCCCS Connect, a new feature that sends personalized program reminders and updates to Medicaid applicants and members to guide them through every step of their Medicaid lifecycle, from initial application through annual renewal.
AHCCCS Connect sends SMS texts, automated voice calls, and/or emails to members who provide valid phone numbers and/or email addresses.
To receive these communications, AHCCCS members need to provide a phone number capable of receiving text messages, and/or an email address in their Health-e-Arizona Plus (HEAplus) account at www.healthearizonaplus.gov. New applicants will be automatically added to AHCCCS Connect when they provide an email address and/or cell phone number. Members are able to opt out of AHCCCS Connect at any time, and may rejoin at any time.
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Carmen Hereida, Cabinet Executive Officer and Executive Deputy Director, and AHCCCS staff recently toured St. Vincent De Paul's Phoenix Family Dining Room, Resource Center, and Ozanam Manor Transitional Housing for seniors, veterans, and adults with disabilities. During the tour, Heredia met some of the dedicated staff members who work to feed, clothe, house, and heal Arizonans in need.
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Ms. Heredia delivered the keynote speech at the 2023 National Association Of Medicaid Program Integrity Conference, highlighting the 5 C’s approach -–compassion, commitment, competency, clarity, confidence– that AHCCCS took in its response to the fraudulent behavioral health billing schemes the agency uncovered this year. |
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Medicaid Redeterminations: Implications & Transitions” Kristen Challacombe, Deputy Director of Operations
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“Efforts to Promote Sustainable Housing through Policy” Elizabeth Da Costa, Housing Administrator
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“Progress & Challenges in Treating Addiction” Dr Sara Salek, Deputy Director and Chief Medical Officer
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"Issues and Initiatives in Tribal Healthcare" Marcus Johnson, Deputy Director of Community Engagement and Regulatory Affairs
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Helping Members Enroll and Renew
Stopping Provider Fraud and Protecting Members
Expanding Covered Service
Addressing Healthcare Workforce Needs
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AHCCCS Community Forum
Mon., Oct. 16, 10:00 a.m.—noon, online on Zoom
AHCCCS Community Forum is a two-hour event to inform and gather feedback from the community on AHCCCS updates and initiatives. This month’s topics include; Member Exploitation and Fraudulent Billing Update, Transformative Health Care Scholarships, Targeted Investment 2.0, State Plan Updates, Unwinding and Eligibility Updates, and PAXIS Tools.
Jacob’s Law Training
Thurs., Oct. 19, 10:00 a.m.— noon, online on Zoom
This training will cover Jacob’s law, review and use of the DCS placement packet, legal rights and protections of children and resource parents, and covered services.
OIFA Health Care Navigation
Tues., Oct. 24, noon—12:30 p.m., online on Zoom
Join us to learn about the Crisis Services available to anyone experiencing a behavioral health crisis in Arizona. Crisis services are intended to stabilize an individual or prevent a sudden, unanticipated, or potentially dangerous behavioral health condition, episode, or behavior. Services are available to anyone in Arizona regardless of insurance coverage.
Office of Human Rights Training: The Power of Collaboration and Advocacy for Individuals Living with a Serious Mental Illness
Thurs., Oct. 26, 1:00 p.m.—2:30 p.m., online on Zoom
Join us to learn more about the Power of Collaboration and Advocacy as it pertains to individuals living with an SMI.
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