Our annual data edition focusing on the Arizona Health Care Cost Containment System (AHCCCS) covers a lot of territory and 15 pages to help readers keep tabs on the agency charged with overseeing the managed care plans contracted with the state to deliver care to about 2.2 million Arizona Medicaid members.
Correction: On Page 4 the...
More fraudulent sober living home operators were charged by the state of Arizona this week for patient referral kickback schemes. Arizona Health Care Cost Containment System (AHCCCS) Cabinet Executive Officer Carmen Heredia is calling for an overhaul of the state Medicaid system after spending the first year of her position focusing on...Arizona News
Gene therapies, which treat diseases at the genetic level, are becoming increasingly popular for pharmaceutical manufacturers as the efficacy of directly working with the human genome shows promise for effective health outcomes. But as the U.S. Food and Drug Administration approves them for use in the U.S., these drugs carry a hefty...Arizona News
As the state crackdown on fraudulent Medicaid-funded substance abuse recovery homes across Arizona continues, stories of patients impacted by the programs are emerging.
The facilities would operate under generic names like "Healing Fountain," "Happy Valley," or "Angelic Behavioral Health," and registered with the state as counseling...Arizona News
About a third of Arizona Medicaid members (128,960) were disenrolled for procedural reasons, which means although the Arizona Health Care Cost Containment System (AHCCCS) had information the member was ineligible, they failed to respond to the agency's request for information during the renewal process.
The unwinding from the...
Arizona Health Care Cost Containment System (AHCCCS) is investing $47.5 million from ARP Awards to help strengthen HCBS in Arizona.
Starting on December 4, 2023, eligible HCBS providers can apply for up to $1 million for programmatic or infrastructure projects to improve HCBS for round 2 of the ARP Program Awards. All applications...
The Arizona Attorney General's Office is continuing its massive investigation into fraudulent substance abuse recovery homes that target Native Americans.
Last week, the AG's office announced that the Better You Wellness Center LLC's two owners and its biller were indicted on charges of fraudulently billing the Arizona Health Care...Arizona News
In an effort to protect abused, neglected, and vulnerable ALTCS members, AHCCCS and DES have published two surveys available for ALTCS members and ALTCS members' families through November 17, 2023.
The surveys and evaluations are conducted by the University of Arizona’s Sonoran Center for Excellence in Developmental Disability. All...Arizona News
AHCCCS released a new Olmstead Plan that outlines priorities within the healthcare delivery system for people at risk of institutionalization, including those with behavioral needs and members enrolled in the Arizona Long Term Care System (ALTCS).
The 1999 United States Supreme Court Olmstead decision provided a legal framework for...Arizona News
Arizona's Medicaid program announced this week that it hit the mid-point of the renewal process and boasted one million retentions to the program. During the quarterly Arizona State Medicaid Advisory Committee (SMAC) meeting this week, AHCCCS reported since April 2023, those losing Medicaid coverage in the state total 320,000 with...Arizona News
Hundreds of people are being left homeless after the rapid closure of sober living homes across the state, following an investigation into addiction recovery facilities that sought to defraud the Arizona Health Care Cost Containment System (AHCCCS) and target Native Americans.
A large sober living facility, Ocotillo Apartments and...Arizona News
More details are emerging about the hundreds of fraudulent recovery centers in Arizona that preyed on Indigenous Americans in exchange for Medicaid reimbursements.
The loophole in question is one that allows any Native American in the U.S. to seek substance abuse recovery in Arizona through the Arizona Health Care Cost Containment...Arizona News
Between April 2023 and March 2024, eligibility for every AHCCCS member will be redetermined with more than 650,000 expected to lose coverage. Members who are factually or procedurally ineligible will be disenrolled, and those factually ineligible will be referred to the federal Marketplace.
With the “great unwinding” looming over...National News
The Centers for Medicare and Medicaid Services (CMS) Innovation Center announced a new state-based payment model focused on population health.
The Advancing All-Payer Health Equity Approached and Development Model (AHEAD Model) will be offered to up to eight states with $12 million allotted per participating state. Modern Healthcare...National News
A new class of highly popular diabetes drugs have changed the landscape for conventional wisdom on obesity and weight loss, but cost of the drug and weight stigma are preventing the drug from widespread authorization by insurers, including Medicare.
Ozempic and its sister drug Wegovy, produced by NovoNordisk, were the first of two...Arizona News
House Bill 2691 sets up The Maricopa County Community College District (MCCCD) and Northland Pioneer College to receive $9 million in funds collectively from the American Rescue Plan to combat Arizona's behavioral health workforce shortages.
According to The Arizona Behavioral Health Workforce (AZBH), 40% of Arizonans live in...Arizona News
It's difficult to say how Medicaid redeterminations are going.
At least 4,777,000 Medicaid enrollees have been disenrolled across the country as of August 15. The KFF Disenrollment Tracker has found that there's large discrepancies in enrollment data state-by-state, with Texas disenrolling the vast majority of its Medicaid population...
Women are facing dwindling options for maternity care across the country, especially in rural and aging areas, according to an updated report on maternity unit accessibility by the March of Dimes.
The update to the 2022 annual report by maternity care advocacy group March of Dimes found that 1,119 counties across the U.S. qualify as...
The Arizona Health Care Cost Containment System (AHCCCS) has released a Request for Proposal (RFP) to solicit participation by Managed Care Organizations (MCOs) to provide health care services to members of the Arizona Long Term Care System (ALTCS) who are elderly and/or who have a physical disability (EPD).
As of July 1, 2023,...
