On Tuesday, AHCCCS, Arizona’s version of Medicaid, notified five health care plans involved with the state’s long-term care program that it will extend a one year contract to current carriers. The decision affects thousands of seniors and people with physical disabilities.
Members of Arizona Long-Term Care System, known as ALTCS, will now remain with their current health plan until 2025. Members were supposed to switch to new health insurance plans on Oct. 1 of this year.
David Voepel is the CEO of the Arizona Health Care Association. He says this could affect case managers who are responsible for maintaining records for each member.
"If you have a case manager that was slated to go from a current company to a new company starting Oct. 1, and now the old company needs to continue with that case manager, what's going to happen with the case manager's position at the new company?"
Voepel says this story is far from over. He does says the agency should be commended for taking the time to hopefully get it right.
"They want to be meticulous about this … they don't want to go from something that makes things worse, it's difficult to do because you're talking 26,000 lives."
So what happened?
In August, a judge determined that Arizona Health Care Cost Containment System had improperly issued contracts to health care companies that provide long-term care services to 26,000 older adults and people with physical disabilities.
These individuals are part of ALTCS. ALCTS pays for a variety of medical and non-medical services, including nursing home care.
Days after the judge issued their decision, AHCCCS paused the Oct. 1 transition to the new health plans. Members were told that they would remain on their current health plan until further notice.
AHCCCS had until Sept. 8 to decide if it was going to accept, reject or modify the judge’s recommendations.
On Sept. 9, AHCCCS issued a Director’s Decision, disagreeing with the judge's recommendation. The agency stated that it had exercised its discretion in the procurement process in accordance with law.
It went on to say that the non-awarded health plans, which includes Mercy Care, Banner and Blue Cross and Blue Shield, will have the opportunity to either file a ‘Motion for Rehearing or Review’ with the agency or file an appeal in Superior Court.
AHCCCS released a statement about the contracts:
"AHCCCS plans to extend the current Arizona Long Term Care System for Elderly and/or Physically Disabled (ALTCS-EPD) Contracts with Banner-University Family Care, Mercy Care, and UnitedHealthcare Community Plan for one year, through September 30, 2025. This follows the recent Director’s Decision to deny the appeal of the EPD award protesters.
"In light of the final Agency decision, AHCCCS is evaluating operations and processes to ensure a smooth transition to the newly awarded ALTCS-EPD health plans, which are anticipated to begin on October 1, 2025. The health plans which were awarded EPD contracts are Health Net Access, Inc. (dba Arizona Complete Health-Long Term Care Plan) and Arizona Physicians IPA, Inc. (dba UnitedHealthcare Community Plan).
"AHCCCS will provide additional information and finalize updated contracts in the coming days. We want to ensure public awareness of the timelines associated with the EPD contract awards.
"Previously scheduled Community Forums to address questions and hear from members and the community about the transition will be rescheduled. This postponement will allow AHCCCS to provide the most current information during the rescheduled forums, ensuring meaningful and accurate conversations.
"We understand this process may cause challenges and confusion. Please be assured that AHCCCS will communicate the next steps as soon as possible.
For more information regarding the Director’s Decision, please visit the AHCCCS website or contact [email protected]. "
