The question of who will provide services to thousands of Arizonans is on hold following a court decision.
On Friday, an administrative law judge determined that AHCCCS — Arizona Health Care Cost Containment System, Arizona’s version of Medicaid — had improperly issued contracts with health care companies that provide services to 26,000 older adults and people with disabilities.
These individuals are part of the Arizona Long Term Care System, known as ALTCS, which provides long term care services. The administrative law judge determined that AHCCCS’ process to award new health plan contracts was seriously flawed
ALTCS members were supposed to be transitioned to new health plans on Oct. 1. But earlier this year, three health plans, Mercy Care, Health Choice and Banner-University Family Care, appealed. The judge agreed with their concerns and concluded that the awards made by AHCCCS "did not comply with statutes and regulations or were otherwise improper."
David Voepel is the CEO of the Arizona Health Care Association, which represents skilled nursing homes.
"And the administrative law judge ruled on Friday, they said that AHCCCS did some things that weren't kosher, and that they should redo the award, for all for all intents and purposes."
Days later, AHCCCS posted a statement online saying it was pausing the transition. Still, says Voepel, "There have been letters that have gone out from AHCCCS to the residents saying, ‘Hey, we're going to transition you over to a new company.’ So, there have been a lot of things that have been happening behind the scenes, so that you get ready for this Oct. 1 date."
So what does this mean for those 26,000 members? According to AHCCCS, individuals enrolled with those health plans will not need to take any action. Instead, the agency has decided to pause the transition.
Members will be notified of the pause via mail and email.
