Magellan Health Services

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AHCCCS & ADHS/DBHS

Updates from the Arizona Department of Health Services/Division of Behavioral Health Services

DBHS adoption of SAMHSA Practice Models

In May 2012, the State of Arizona, the Arizona Department of Health Services (ADHS) and the Plaintiff through counsel, in the Arnold vs. Sarn matter signed an Agreement outlining service delivery obligations for adults with Serious Mental Illness (SMI) in Maricopa County covering the period of July 1, 2012 through June 30, 2014. As set forth in the Agreement, ADHS has notified Magellan that it is officially adopting four evidence-based practice models endorsed by the Substance Abuse and Mental Health Services Administration (SAMHSA) and reflective of national standards of care. Click HERE to read more about DBHS' adoption of SAMHSA Practice Models.

Updates from AHCCCS

New AHCCCS Provider Re-Enrollment Webpage 

As mandated by the Department of Health and Human Services, Centers for Medicaid and Medicare services, and in accordance with the Affordable Care Act, Section 6401, all providers registered with AHCCCS are required to re-enroll. AHCCCS has set up a re-enrollment webpage under the Plans/Providers page on the AHCCCS website. Providers should visit this webpage to obtain more information on the new requirement. For additional information and support, please view the FAQ.

AHCCCS Non-Emergency Medical Transport Providers--Taxi Copayment Requirements Effective April 1, 2012

The Federal Centers for Medicare and Medicaid Services (CMS) recently approved a $2.00 mandatory copayment for taxi services per one-way trip for certain AHCCCS members residing in urban counties. This memorandum provides general information regarding this copayment requirement that will become effective April 1, 2012. A sample table with copayment information for AHCCCS members accompanies this memo. 

AHCCCS members who will have mandatory copayments for taxi services beginning April 1, 2012 are:

  • Childless Adults (in the table, the Childless Adult population is designated as member Copay Level of 40):
    • who reside in Maricopa and Pima Counties, and
    • who are aged 19 and older, and
    • who are enrolled in an AHCCCS Health Plan

["Childless Adults" are also referred to as "AHCCCS Care" or the "TWG (Title XIX Waiver Group) Population."]

Providers impacted by this mandatory copayment include those who provide transportation via a "taxi," which is defined as a vehicle that has been issued a taxi special license plate pursuant to A.R.S. § 28-2515.

Mandatory copayments permit providers to deny services to members who do not pay the $2.00 copayment. The $2.00 copayment will be charged each time a taxi is called.  If a taxi waits for a member, e.g., while the member picks up a prescription, then a $2.00 co-pay cannot be charged for the continuation of the one-way trip. Specific members are exempt from copayments, for example, persons determined to be Seriously Mentally Ill (SMI) by the Arizona Department of Health Services (in the table, exempt members are designated as a Member Copay Level of 00).  Please be aware that payments to providers will be reduced by the amount of a member's copayment obligation regardless of whether or not the provider successfully collects the mandatory copayment. 

AHCCCS' Managed Care Organizations primarily contract with one transportation brokerage for transportation services.  In this case, the brokerage will notify their taxi drivers when an AHCCCS member approved for taxi services is a Childless Adult who is subject to the $2.00 per one-way copayment.  Contractors who do not have an exclusive arrangement with a transportation brokerage will directly provide the notification of a copayment requirement to the transportation provider when scheduling the transportation for the member. 

Resources:

Important Changes to AHCCCS--MVD Photos Added To AHCCCS Online Eligibility Verification

Effective Thursday, Dec. 15, 2011, AHCCCS will be adding photos to its online verification tool that providers use to verify member eligibility. This new feature is one of many efforts by AHCCCS to help protect members and prevent fraud. AHCCCS will obtain photos from the Arizona Department of Transportation Motor Vehicle Division (MVD) of all AHCCCS members who have an Arizona driver's license or a State issued Identification (ID) Card. When providers use the online member verification system and enter a member's social security number, the member's photo, if available from MVD, will be displayed on the AHCCCS eligibility verification screen along with other AHCCCS coverage information. The added photo image will assist AHCCCS providers to quickly validate the identity of a member.

Member Notice: AHCCCS members will be notified of this change through the member portals on the AHCCCS internet website. AHCCCS and its Contractors will also notify members via newsletters and the handbooks. In the future, members will be informed about the addition of MVD photos on their AHCCCS ID card carriers as well as in the Welcome Back letters.

Provider Information/Requirements: Providers are reminded of their continuing obligation to comply with all requirements of the AHCCCS Provider Participation Agreement as a condition of participating in the AHCCCS Program. Paragraph 25 of the Agreement states: "If Provider or any employee or contractor of Provider discovers, or is made aware, that an incident of potential fraud or abuse has occurred, the Provider shall report the incident to the AHCCCS Office of Inspector General (AHCCCS OIG) in accordance with state statutes and AHCCCS policy."

In addition, Arizona Laws ARS §§ 36-2905.04 and 2918.01 require providers to cooperate with AHCCCS to prevent and discover eligibility fraud and to immediately notify AHCCCS of any cases of suspected fraud or abuse.

For the latest information regarding this change, please visit AHCCCS' news and upate portal at http://azahcccs.gov/shared/news.aspx (refer to second bullet on MVD change).

Health-e-Arizona training

AHCCCS provides monthly training to the community on different topics that may be useful to subscribers of their Health-e-Arizona system. The Health-e-Arizona system is an electronic system that allows recipients to apply for AHCCCS benefits online. Click here to view a webinar on "Applying for SMI Applicants Using Health-e-Arizona." Users who have logged into Health-e-Arizona can find the list of upcoming webinars on the Health-e-Arizona site. Select "Links and Contacts" and then "HEALTH-E-ARIZONA 2011 TRAINING."



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If you are in crisis, call the Crisis Line at (800) 631-1314, TTY (800) 327-9254. For emergencies, always call 9-1-1

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Contact Information

Mercy Maricopa Integrated Care (Mercy Maricopa) is now the Regional Behavioral Health Authority (RBHA) serving members in the Maricopa County Region. For questions regarding your services, please call 1-800-564-5465 or TDD/TTY 711.

** To file a grievance or appeal for services provided on or before March 31, 2014 please call Magellan Health Services 602-652-5907, x8590