Last week, a judge determined that AHCCCS, Arizona’s version of Medicaid, had improperly issued contracts to health care companies that provide services to older adults and people with disabilities. AHCCCS had planned to transition members to the new plans in October. AHCCCS now has until Sept. 9 to figure out what to do.
These individuals are part of ALTCS, which provides long-term care services. After the judge made their decision, AHCCCS announced it would pause the transition and members would remain with their current health plan for the foreseeable future.
Cynthia Macluskie is a Medicaid advocate. "But they're making the assumption that people who purposely made a change didn't want to make that change," she said.
Macluskie says she’s unclear how the agency can just go back since contracts were signed between carriers and providers…
"So a lot of things have changed and I don't know how you unwind that necessarily. I mean, it's a happy thought to say, 'oh, we're just going back to the way it was.' But members made changes, providers made changes, carriers made changes, and they don't just automatically rewind because AHCCCS says rewind them."
These members were supposed to be transitioned to new health plans on October 1st. Now it's unclear what will happen to this incredibly vulnerable population.
"And it wasn't easy for them to qualify for those services. ... And so being this disruptive to that segment of the population is just highly concerning. And I think they should have more choice, not less."
According to a court document, AHCCCS team members considered the administrative burden as a reason for awarding fewer total contracts. Members were able to pick from two plans instead of three.
