A judge recently determined that AHCCCS — Arizona’s version of Medicaid — had improperly issued contracts to health-care companies that provide long-term care services to 26,000 older adults and people with physical disabilities.
The question now is, what should the agency do next?
AHCCCS has until Sept. 8 to decide if it's going to accept, reject or modify the judge’s recommendations.
"I think the only option that makes sense is that they start over," says Anne Ronan, a staff attorney with the Arizona Center for Law and the Public Interest.
She says even before the decision came down, there were problems with the transition of ALTCS members to the new health plans.
"Families had not gotten notice in a timely way of the change and that they had to make a decision for a new plan within a very short period of time. Now AHCCCS has extended that, but in the meantime, all of their providers were scrambling to try to get on contracts with these new plans," Ronan said.
The agency had also reduced the number of health plans from three to two. And Ronan says it appeared that AHCCCS didn't take geography into account.
"Just because you've got a statewide contract doesn't mean that that particular provider has providers in St. John's or some of the more remote areas that are really hard to serve," Ronan said.
Ronan and other advocates will be sending their recommendations in writing to AHCCCS’ executive deputy director.
If AHCCCS decides to start the RFP process over, Ronan says the member's original health plan would stay the same until a new process is successfully completed.
An AHCCCS spokesperson told KJZZ earlier this week that emails are being sent to members. They should also expect something in the mail. The messages say to ignore any previous notices about changes to the ALTCS health plans.
If ALTCS-EPD members need to update their email address or mailing address, they can call: 1-888-621-6880.
