Thousands of elderly and physically disabled members of Arizona’s Long-Term Care System could soon be transitioned to new health plans. The change has been described as confusing by some.
ALTCS members have only been told that they will remain with their current health plan until further notice. This, after a judge said that AHCCCS had improperly issued contracts to two health insurance plans. The agency then went on to disregard that judge’s recommendations, saying “properly exercised its discretion in the procurement process.”
Anne Ronan is a staff attorney at the Arizona Center for Law in the Public Interest.
Ronan, who does not represent any of the parties involved, says she’s surprised by what has transpired over the past several weeks and months.
"AHCCCS has done this kind of work for many, many, many years. ... But I don't remember anything quite this disruptive and confusing and out of character; out of sync."
Ronan says the three plans that were not awarded contracts may soon decide to take legal action. And why AHCCCS may be proceeding with caution.
"But if they start this transition again and in the middle of it, and it's thrown up in the air again and all the cards come down again, I just think that is really potentially harmful to members, and we should avoid that at all costs."
Those three health plans told KJZZ News that they were considering next steps.
Banner Health statement
We are disappointed by AHCCCS’s choice to not uphold the Administrative Law Judge’s Decision. A neutral and impartial judge presided over weeks of hearings during which she heard first-hand testimony and reviewed documents confirming the serious flaws in the AHCCCS ALTCS RFP process and decision. AHCCCS has chosen to ignore the ALJ’s unbiased decision, in self-defense of its flawed process.
We are still in the process of reviewing the decision from AHCCCS, issued yesterday by Deputy Director of Community Engagement and Regulatory Affairs Marcus Johnson. We are contemplating our next steps, which may include the filing of a motion for rehearing or an appeal to the Superior Court.
We will continue to advocate in our members’ best interests and believe strongly that staying the existing contracts and reissuing a fair and compliant RFP process is the right course of action. — Banner Health Spokesperson
Mercy Care statement
On September 8, the Arizona Health Care Cost Containment System (AHCCCS) issued the final agency decision on Mercy Care’s appeal of the procurement award for the Arizona Long Term Care System/Elderly & Physically Disabled (ALTCS-EPD) contract. The decision accepted, rejected and modified various findings of fact and conclusions of law made by the Administrative Law Judge (ALJ), which ultimately concluded with a denial of Mercy Care's appeal.
We are disappointed in this denial given the thorough review and recommendation provided by an independent and impartial ALJ. We are reviewing the next available steps as part of the appeal process, and we call on AHCCCS to implement a stay to avoid unnecessary disruption to member care until those legal processes have concluded.
Mercy Care is grateful to our community for all the support we've received throughout this process. As a reminder, Mercy Care remains an AHCCCS health plan—this ruling does not have any effect on our ACC-RBHA, ACC-RBHA with SMI, DDD, Mercy Care Advantage or DCS-CHP contracts.
Blue Cross Blue Shield of Arizona Statement
AZ Blue is reviewing the decision and considering next steps. Our priority is that the people of Arizona, especially our most vulnerable communities, have access to quality care.
