The PsychU Guide To€¦ · 10. Arizona Medicaid Managed Care 11. Arizona Medicaid Medical & Health...

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The PsychU Guide To The Arizona Mental Health

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1. Health Care Coverage Map Of Arizona2. Population Distribution By Payer:

National vs. State 3. Largest Health Plans In Arizona By

Enrollment4. Largest Health Plans in Arizona By SMI

Enrollment5. Arizona Medicaid System Overview6. Arizona Medicaid Governance7. Arizona Medicaid System Benefits8. Arizona Medicaid Financing & Service

Delivery9. Arizona Medicaid Fee-For-Service10. Arizona Medicaid Managed Care11. Arizona Medicaid Medical & Health

Home Initiatives

12. Arizona State Mental Health & Addiction Treatment Department Organization Chart

13. Arizona State Mental Health & Addiction Treatment Department Governance

14. Arizona State Psychiatric Institutions15. Arizona Accountable Care Organizations

(ACOs)16. Arizona Health Care Reform Initiatives17. Arizona Health Insurance Marketplace

Plans18. Arizona Essential Health Benefit

Benchmark Plan

3

The PsychU Guide To Mental Health Payers In Arizona - Contents



Health Care Coverage Map Of Arizona

4




16%

13%

2%

49%

2%2%

9%

ArizonaMedicaid 16%Medicare 13%Medicaid Expansion 7%Dual Eligibles 2%Commercial 49%Health Insurance Marketplace 2%Other Public 2%

14%

14%

5%

2%53%

3%1%8%

NationalMedicaid 14%Medicare 14%Medicaid Expansion 5%Dual Eligibles 2%Commercial 53%Health Insurance Marketplace 3%Other Public 1%

5

2. Population Distribution By Payer: National vs. State

*Based on 2011-2012 data

Total Population: 6,578,900 Total Population: 310,917,000



Basic StandardStarter Premium

3. Largest Health Plans In Arizona By Enrollment

6

*Based on enrollment as of fourth quarter 2013

Plan Name Plan Type Enrollment*Blue Cross Blue Shield of Arizona, Inc. Commercial 1,117,656

Medicare Fee-For-Service (FFS) Medicare 574,895

UnitedHealth Commercial Administrative Services Only (ASO)

341,512

United Healthcare Medicaid 336,119

Mercy Care Plan Medicaid 298,196

UnitedHealthcare Insurance Company Commercial 218,344

Cigna Commercial ASO 216,098

Aetna Commercial ASO 199,863

Health Choice Medicaid 198,680

Medicaid FFS Medicaid 175,134




7

4. Largest Health Plans in Arizona By SMI Enrollment

*Based on enrollment as of fourth quarter 2013

Plan Name Plan Type Enrollment* Estimated SMI Enrollment

Medicare FFS Medicare 574,895 50,016

United Healthcare Medicaid 336,119 16,806

Mercy Care Plan Medicaid 298,196 14,910

Health Choice Medicaid 198,680 9,934

Medicaid FFS Medicaid 175,134 8,757

PacifiCare of Arizona, Inc. Medicare 92,682 8,063

Blue Cross Blue Shield of Arizona, Inc.

Commercial 1,117,656 7,824

University Family Care Medicaid 127,524 6,376

Care 1st Arizona Medicaid 101,472 5,074

Health Net Access Medicaid 79,380 3,969



8

5. Arizona Medicaid System OverviewMedicaid System GovernanceState Medicaid Director Thomas J. Betlach

State Medicaid Director reports to Janet K. Brewer, Governor

Medicaid Financial Delivery SystemState participating in Medicaid expansion? Yes

Is managed care mandatory for populations with SMI? Yes

Is managed care mandatory for dual eligibles? Yes

Total Medicaid population distribution 11% in FFS89% in Managed Care

Medicaid beneficiaries with SMI: Primary service system Because the SMI population must enroll in managed care unless they meet one of the FFS qualifications, the majority of the SMI population is served by managed care.

Medicaid Financing & Risk Arrangements: Behavioral HealthTraditional Behavioral Health Services • Acute MCOs and Arizona Long-Term Care Services (ALTCS): Included in the MCO’s

capitation rate• Maricopa County SMI Population: Included in Mercy Maricopa’s capitation rate

Specialty Behavioral Health Services • Acute MCOs and ALTCS: Covered by the Regional Behavioral Health Authorities (RBHAs) and excluded from the MCO’s capitation rate.

• Maricopa County SMI Population: Included in Mercy Maricopa’s capitation rate

Pharmaceuticals • Acute MCOs and ALTCS: Antipsychotics covered by the RBHAs, all other pharmacy included in the MCO’s capitation rate

• Maricopa County SMI Population: Included in Mercy Maricopa’s capitation rate



9

6. Arizona Medicaid Governance



10

6. Arizona Medicaid Governance

Name Position Department Thomas J. Betlach

Director Arizona Health Care Cost Containment System (AHCCCS)

Beth Kohler Lazare

Deputy Director AHCCCS

Sara Salek, MD Chief Medical Officer AHCCCS



11

7. Arizona Medicaid System BenefitsFederally Mandated Services

1. Inpatient hospital services other than services in an institution for mental disease

2. Outpatient hospital services 3. Rural Health Clinic services4. Federally Qualified Health Center services5. Laboratory and X-ray services6. Nursing facilities for individuals 21 and over7. Early and Periodic Screening and Diagnosis and

Treatment (EPSDT)8. Family planning services and supplies for

individuals of child-bearing age9. Physician services10. Medical and surgical services of a dentist11. Home health services12. Nurse midwife services13. Nurse practitioner services14. Pregnancy services, including tobacco cessation

programs15. Free standing birth centers16. Non-emergency transportation to medical care

Arizona’s Optional Services

1. Other labs and X-ray services2. Private duty nursing services3. Clinic services4. Dental services5. Physical therapy, occupational therapy, and related

services6. Services for individuals with speech hearing and

language disorders7. Prescribed drugs8. Prosthetic devices and eyeglasses9. Diagnostic, screening services, and preventive

services10. Hospice care11. Respiratory care services12. Personal care services13. Behavioral health14. Services of nurses in religious non-medical health

care institutions 15. Case management and tuberculosis related services16. Inpatient psychiatric facility services for individuals

under 21 years of age17. Services for individuals over age 65 in an institution of

mental disease (IMD)



12

8. Arizona Medicaid Financing & Service Delivery

Medicaid System CharacteristicsCharacteristics Medicaid Fee-For-Service (FFS) Medicaid Managed Care (MC)

June 2014 Enrollment 175,134 1,281,156

SMI Enrollment Because the SMI population must enroll in managed care unless they meet one of the FFS qualifications, the majority of the SMI population is served by managed care.

Management AHCCCS • Acute Care: Eight acute MCOs• ALTCS: Three long-term and

acute care MCOs• Behavioral Health: Six RBHAs

Payment Model Fee-for-service Capitated rate (all)

Geographic Service Area Statewide Statewide operating on a regional basis (all)

Total Medicaid 1,456,990 | Total Medicaid With SMI 29,000



13

9. Arizona Medicaid Fee-For-Service

Optional Enrollment In FFSThe only population eligible to enroll in the FFS program is the American Indian/Alaskan native population.

• The FFS program for American Indians is called the American Indian Health Program (AIHP). They are able to receive service from any AHCCCS provider, Indian Health Service (IHS) facility, or a tribally operated (638) facility on a fee-for-service basis.

• American Indians are able to switch back and forth from a AHCCCS managed care plan to AIHP at any time.

Fee-for-service enrollment as of September 2014 was 175,134.



Arizona Medicaid Fee-For-Service

14

1. Behavioral management2. Case management3. Emergency behavioral health care4. Evaluation5. Therapeutic residential support (in-home, excludes room and board)6. Inpatient hospital7. Inpatient psychiatric facilities8. Psychotropic medications9. Medication adjustment and monitoring10. Methadone11. Partial care12. Individual, group, and family professional services13. Psychosocial rehabilitation14. Respite15. Screening

American Indians may elect to receive services from a Tribal/Regional Behavioral Health Authority (described in B.7.) or from a 638 or IHS facility.

FFS Mental Health Benefits:



10. Arizona Medicaid Managed Care

15

• Managed care enrollment as of September 2014 was 1,281,856.

• Arizona has two Medicaid programs to serve Medicaid enrollees: – Acute Managed Care Organizations (MCOs): Provide acute care services

through eight prepaid, capitated MCOs. MCOs are available by geographic service area (GSA), which refers to either one specific county or a grouping of counties. Enrollees in the acute MCO program can choose any plan available in their GSA.

– Arizona Long-Term Care System (ALTCS): Provide acute care and home and community based services (HCBS) for those who are 65 and older, blind, disabled, and have a medical need for LTSS. Services are provided through three prepaid capitated MCOs that are available by GSA. Enrollees in the ALTCS program only have a choice of MCO, if there is more than one ALTCS MCO in their GSA.



Arizona Medicaid Managed Care Program: Health Plans by GSA

16

GSA Counties Acute MCOs ALTCS MCOs2 La Paz, Yuma UnitedHealthcare, University Family

CareUnitedHealthcare LTC

4 Mohave, Coconino, Navajo, Apache

Health Choice Arizona, UnitedHealthcare

UnitedHealthcare LTC

6 Yavapai UnitedHealthcare, University Family Care

UnitedHealthcare LTC

8 Gila, Pinal Health Choice Arizona, University Family Care

Bridgeway Health Solutions

10 Pima, Santa Cruz Mercy Care Plan, UnitedHealthcare, Health Choice Arizona, Care 1st Arizona, University Family Care

Mercy Care Plan LTC,UnitedHealthcare LTC,

12 Maricopa Care 1st Arizona, Health Net Access, Health Choice Arizona, Maricopa Health Plan, Mercy Care Plan, Phoenix Health Plan, UnitedHealthcare

Mercy Care Plan-LTC, Bridgeway Health Solutions, UnitedHealthcare LTC

14 Graham, Cochise,Greenlee

UnitedHealthcare, University Family Care

Bridgeway Health Solutions



Arizona Medicaid Managed Care

17

• Acute MCOs and ALTCS: Behavioral health services are not provided by the health plan, but are the responsibility of prepaid inpatient health plans (PIHPs), known as Tribal/Regional Behavioral Health Authorities (T/RBHA). – Primary care physicians are able to provide medication

management for anxiety, depression, and attention deficit hyperactivity disorder (ADHD).

• The RBHAs are divided into six GSAs that are similar to, but not the same as, the acute care GSAs.

• American Indians in managed care can either receive services through the RBHA or TRBHA.



Arizona Medicaid Managed Care: Behavioral Health Benefits

18

• Behavioral management• Case management• Emergency behavioral health care• Evaluation• Therapeutic residential support (in-home, excludes room and board)• Inpatient hospital• Inpatient psychiatric facilities• Psychotropic medications• Medication adjustment and monitoring• Methadone and IAAM • Partial care• Individual, group, and family professional services• Psychosocial rehabilitation• Respite• Screening



Arizona Medicaid Managed Care Program: RHBAs By County

19

GSA Counties RBHA

1 Mohave, Coconino, Navajo, Apache, Yavapai

Northern Arizona Regional Behavioral Health Authority (NARBHA)

2 La Paz, Yuma Cenpatico 23 Greenlee, Graham, Cochise,

Santa CruzCenpatico 3

4 Gila, Pinal Cenpatico 45 Pima Community Partnership of Southern Arizona6 Maricopa Mercy Maricopa Integrated TRBHAs (serves members located on the Tribe’s reservation) Gila River CommunityNavajo NationPascua Yaqui TribeWhite Mountain Apache Tribe of Arizona Colorado River Tribe- only provides state subsidized services



Arizona Medicaid Managed Care: SMI Population

20

• Individuals with SMI are not exempt from enrolling in managed care unless they also meet one of the fee-for-service criteria.

• If an individual resides in Maricopa County and has SMI, they will receive behavioral and acute services through an integrated specialty RBHA. See slide 32 for more information.

• The integrated specialty RBHA, Mercy Maricopa, began operating in 2014. Previously the contract was held by Magellan, which operated as a standard RBHA.

• Medicaid expansion population, if medically frail, must be offered the full array of State Plan benefits. Medically frail individuals include adults with serious mental illness and chronic substance abuse disorders.



Arizona Medicaid Managed Care: Plans By County

21

Mercy Maricopa Integrated Care 2014TargetPopulation

Medicaid and dual eligible enrollees with SMI: approximately 18,000 individuals

Care Delivery Model

Services provided through the health homes model

Care Coordination ServiceRequirements

• Co-located services in existing SMI clinics, called Whole Health Clinics • Primary Care Physician (PCPs) act as patient centered medical homes or virtual health homes

for those who choose to not receive services at whole health clinic • Member centered goals and recovery model• Development of an Individual Recovery Plan • Enhanced care coordination

Payment Model Per member per month (PMPM) capitated rate: $2,341.37

Benefits • Physical health benefits• Behavioral health benefits, plus supported housing, supported employment, Assertive

Community Treatment (ACT), and consumer operated programs

Practice Performance & Improvement

• State specified minimum standards and goals, including inpatient utilization, hospitalreadmissions, emergency department utilization, comprehensive diabetes management, and access to a PCP

• Performance improvement projects



• Arizona applied for and received funding through a 2011 planning grant to determine the feasibility of health homes for populations with SMI.

• As of October 2014, health homes’ functions are being provided by behavioral health organizations to meet care coordination requirements. There is no official SPA or legal entity requiring them to create health homes.

11. Arizona Medicaid Medical & Health Home Initiatives

22



12. Arizona State Mental Health & Addiction Treatment Department Organization Chart

2323



13. Arizona State Mental Health & Addiction Treatment Department Governance

24

Name Position DepartmentWill Humble Director Arizona Department Cory Nelson Deputy Director ADPH Division of Behavioral Health

ServicesPaul Galdys Assistant Director Operations and DevelopmentAaron Bowen Assistant Director Quality and IntegrationMargery Ault Assistant Director Compliance and Consumer RightsSteven F. Dingle, M.D.

Chief Medical Officer Behavioral Health Services

Cynthia Layne Chief Financial Officer Bureau of Financial Operations

Donna Noriega CEO Arizona State Hospital




14. Arizona State Psychiatric Institutions

25

Institution Name Location Beds FY 2013 Admissions

FY 2013Discharges

2013Average Daily Census

Arizona State Hospital

Phoenix 260 64 55 237



15. Arizona Accountable Care Organizations (ACOs)

26

Medicare Shared Savings Program Pioneer ACO1. Arizona Care Network, LLC 2. Arizona Priority Care Plus3. ASPA-Connected4. GPIPA ACO5. John C. Lincoln Accountable Care Organization,

LLC6. North Central Arizona Accountable Care, LLC7. Premier Care Network, LLC8. Scottsdale Health Partners9. Southern Arizona Accountable Care Organization,

LLC10. Yavapai Accountable Care11. Yuma Connected Community

1. Banner Health Network (Phoenix)



Arizona Accountable Care Organizations (ACOs)

27

Commercial ACOsACO Commercial InsurerBanner Health Network Aetna

Banner Health Network Cigna

Banner Health Network ACO Humana

Cigna Medical Group (CMG) of Arizona Collaborative Accountable Care (CAC)

Cigna




16. Arizona Health Care Reform Initiatives

2828

Medicaid Expansion

Choose to participate in expansion?

Yes

Medicaid Eligibility Income Limit for Childless Adults

133% of FPLNote: The PPACA requires that 5% of income be disregarded with determining eligibility

SpecificLegislation Enacted

House Bill 2010

Health Insurance MarketplaceType of Marketplace

Federal

IndividualEnrollment Contact

www.healthcare.gov

1-800-318-2596

Small BusinessEnrollment Contact

www.healthcare.gov/small-businesses

1-800-706-7893

http://www.healthcare.gov/

http://www.healthcare.gov/small-businesses




17. Arizona Health Insurance Marketplace Plans

2929

Individual Market• Health Net Life Insurance Company• Blue Cross Blue Shield of Arizona• Aetna• Cigna Healthcare• Health Choice Insurance Co. • Health Net of Arizona• Humana Health Plan• Meritus Health Partners • Meritus Mutual Health Partners• University of Arizona Health Plans-

University Healthcare Marketplace

Small Group Market• Health Net Life Insurance Company• Blue Cross Blue Shield of Arizona• Health Net of Arizona• Meritus Health Partners • Meritus Mutual Health Partners



18. Arizona Essential Health Benefit Benchmark Plan

30

Plan Type Plan from largest state employee plan, Exclusive Provider Organization

Issuer Name State of Arizona Self-Insured Plan, administered by United Healthcare

Plan Name Arizona Benefit Options EPO Plan, administered by United Healthcare

Supplemented Categories (Supplementary Plan Type)

• Pediatric Oral (FEDVIP) • Pediatric Vision (FEDVIP)

Habilitative Services Defined by State

No; when the benchmark plan and the state do not define habilitativeservices the benefit is covered using the federal definition; provides parity that are similar in scope, amount, and duration to benefits covered for rehabilitative services.

Biologically Based Mental Illness Covered the same as any other medical benefit as described in the 2008 Mental Health Parity and Addiction Equity Act



Arizona Essential Health Benefit Benchmark Plan

31

Benefit Limit on Service Exclusions (apply to all benefits)

Non

-Bio

logi

cally

Bas

ed M

enta

l Illn

ess

Mental/Behavioral Health Outpatient Services

No None

Mental/Behavioral Health Inpatient Services

No

Substance Abuse Disorder Outpatient Services

90 days per year

Substance Abuse Disorder InpatientServices

No



1. Arizona Health Care Coverage Map1. Arizona Health Care Cost Containment System. Health Plan Contact Information. Retrieved September 14, 2014 from

https://azweb.statemedicaid.us/HealthPlanLinksNet/HPLinks.aspx2. The Henry J. Kaiser Foundation. (2014, April 19). State Health Facts: Health Reform Indicators. Retrieved September 14, 2014 from

http://kff.org/state-category/health-reform/3. Thierer, C. (2014, June 20). QHP Landscape Individual Market Medical. Retrieved July 1, 2014 from

https://data.healthcare.gov/dataset/QHP-Landscape-Individual-Market-Medical/b8in-sz6k4. Thierer, C. (2014, June 20). QHP Landscape SHOP Market Medical. Retrieved July 1, 2014 from https://data.healthcare.gov/dataset/QHP-

Landscape-SHOP-Market-Medical/ss3e-3mza

2. Arizona Population Distribution By Payer: National vs. State 1. Arizona Health Care Cost Containment System. (2014, March 1). Arizona Health Care Cost Containment System- Dual Eligible Enrollment

By County. Retrieved September 14, 2014 from http://www.azahcccs.gov/reporting/Downloads/Integration/ByCounty.pdf2. Centers for Medicare and Medicare Services. (2013, February). Data Analysis Brief Medicare-Medicaid Dual Enrollment from 2006 through

2011. Retrieved September, 14 2014 from http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/Dual_Enrollment_2006-2011_Final_Document.pdf

3. The Henry J. Kaiser Foundation. (2012). State Health Facts: Health Insurance Coverage of the Total Population. Retrieved September 14, 2014 from http://kff.org/other/state-indicator/total-population/

4. The Henry J. Kaiser Foundation. (2014, April 19). State Health Facts: Health Reform Indicators. Retrieved September 14, 2014 from http://kff.org/state-category/health-reform/

5. The Kaiser Foundation definition for Medicaid includes dual eligible individuals. To avoid double counting, the number of dual eligibles was subtracted from the total number of Medicaid enrollees.

6. Other Public refers to military and Veteran’s Administration coverage.

Sources

32

https://azweb.statemedicaid.us/HealthPlanLinksNet/HPLinks.aspx

http://kff.org/state-category/health-reform/

https://data.healthcare.gov/dataset/QHP-Landscape-Individual-Market-Medical/b8in-sz6k

https://data.healthcare.gov/dataset/QHP-Landscape-SHOP-Market-Medical/ss3e-3mza

http://www.azahcccs.gov/reporting/Downloads/Integration/ByCounty.pdf

http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/Dual_Enrollment_2006-2011_Final_Document.pdf

http://kff.org/other/state-indicator/total-population/

http://kff.org/state-category/health-reform/



3. Largest Health Plans In Arizona By Enrollment1. Centers for Medicare and Medicaid Services. (2012). Medicare Geographic Variation State/County Table- All Beneficiaries. Retrieved

September 14, 2014 from http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Geographic-Variation/GV_PUF.html

2. Health Plans USA. (2013). Subscription Database. Available from http://www.markfarrah.com/products/health-plans-usa.aspx3. Arizona Health Care Cost Containment System. (2014, September). AHCCCS Population By Health Care Contractor. Retrieved September

14, 2014 from http://www.azahcccs.gov/reporting/Downloads/PopulationStatistics/2014/Sep/Members_by_Contractor_Report.pdf

4. Largest Health Plans in Arizona By SMI Enrollment1. Centers for Medicare and Medicaid Services. (2012). Medicare Geographic Variation State/County Table- All Beneficiaries. Retrieved

September 14, 2014 from http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Geographic-Variation/GV_PUF.html

2. Health Plans USA. (2013). Subscription Database. Available from http://www.markfarrah.com/products/health-plans-usa.aspx3. Arizona Health Care Cost Containment System. (2014, September). AHCCCS Population By Health Care Contractor. Retrieved September

14, 2014 from http://www.azahcccs.gov/reporting/Downloads/PopulationStatistics/2014/Sep/Members_by_Contractor_Report.pdf

5. Arizona Medicaid System Overview• Compiled from information found throughout the profile.

6. Arizona Medicaid Governance1. Arizona Health Care Cost Containment System. (2014, September 2). Arizona Health Care Cost Containment System Agency

Administration and Management. Retrieved September 14, 2014 from http://www.azahcccs.gov/shared/Downloads/AHCCCSorgchart.pdf

7. Arizona Medicaid System Benefits1. Centers for Medicare and Medicaid Services. Medicaid Benefits. Retrieved September 14, 2014 from http://www.medicaid.gov/Medicaid-

CHIP-Program-Information/By-Topics/Benefits/Medicaid-Benefits.html2. Arizona Health Care Cost Containment System. (2013, April). Arizona Health Care Cost Containment System. Retrieved September 14,

2014 from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/az/Health-Care-Cost-Containment-System/az-hccc-stc-10012011-09302016-amended-042013.pdf

Sources

33

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http://www.markfarrah.com/products/health-plans-usa.aspx

http://www.azahcccs.gov/reporting/Downloads/PopulationStatistics/2014/Sep/Members_by_Contractor_Report.pdf

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Geographic-Variation/GV_PUF.html

http://www.markfarrah.com/products/health-plans-usa.aspx


http://www.azahcccs.gov/shared/Downloads/AHCCCSorgchart.pdf

http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Medicaid-Benefits.html

http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/az/Health-Care-Cost-Containment-System/az-hccc-stc-10012011-09302016-amended-042013.pdf



8. Arizona Medicaid Financing & Service Delivery1. Arizona Health Care Cost Containment System. (2014, September). AHCCCS Population By Health Care Contractor. Retrieved September

14, 2014 from http://www.azahcccs.gov/reporting/Downloads/PopulationStatistics/2014/Sep/Members_by_Contractor_Report.pdf2. Arizona Health Care Cost Containment System. (2013, April). Arizona Health Care Cost Containment System. Retrieved September 14,

2014 from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/az/Health-Care-Cost-Containment-System/az-hccc-stc-10012011-09302016-amended-042013.pdf

9. Arizona Medicaid Fee-For-Service1. Arizona Health Care Cost Containment System. (2013). AHCCCS Behavioral Health Services Guide. Retrieved September 14, 2014 from

http://www.azahcccs.gov/shared/Downloads/EligibilityManual/AEPM/ahcccseligibilitypolicymanual.htm#introduction/quick_start.htm

10. Arizona Medicaid Managed Care• Arizona Health Care Cost Containment System. (2014, August 25). Arizona Health Care Cost Containment System. Retrieved September

14, 2014 from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/az/Health-Care-Cost-Containment-System/az-hccc-stc-10012011-09302016-amended-042013.pdf

Arizona Medicaid Managed Care Program: GSAs1. Arizona Health Care Cost Containment System. (2012). Acute Care Enrollment By County/GSA. Retrieved September 14, 2014 from

http://www.azahcccs.gov/commercial/Downloads/Solicitations/BiddersLibrary/YH14-2. Arizona Health Care Cost Containment System. (2013, October). AHCCCS Contractor Operations Manual. Retrieved September 14, 2014

from http://www.azahcccs.gov/commercial/Downloads/Solicitations/BiddersLibrary/YH14-0001/AcuteNetworkStandardsACOM.pdf

Sources

34



http://www.azahcccs.gov/shared/Downloads/EligibilityManual/AEPM/ahcccseligibilitypolicymanual.htm


http://www.azahcccs.gov/commercial/Downloads/Solicitations/BiddersLibrary/YH14-

http://www.azahcccs.gov/commercial/Downloads/Solicitations/BiddersLibrary/YH14-0001/AcuteNetworkStandardsACOM.pdf



Arizona Medicaid Managed Care Program: Health Plans by GSAs1. Arizona Health Care Cost Containment System. Health Plan Contact Information. Retrieved September 14, 2014 from


Arizona Medicaid Managed Care Program: Behavioral Health Overview1. Arizona Health Care Cost Containment System. (2014, October 1). CYE15 ALTCS EPD Contract Renewal (YH14-0001). Retrieved October

1, 2014 from http://www.azahcccs.gov/commercial/Downloads/ContractAmendments/ALTCS/ALTCSCYE2014/ALTCS_EPD_Amendment10114.pdf

2. Arizona Health Care Cost Containment System. (2014, October 1). CYE15 Acute Care Contract Renewal (YH14-0001). Retrieved October1, 2014 from http://www.azahcccs.gov/commercial/Downloads/ContractAmendments/AcuteCareAmendment10114.pdf

3. Arizona Health Care Cost Containment System. (2014, March). FY2014 Provider Network Development and Management Plan. Retrieved September 14, 2014 from http://www.azdhs.gov/bhs/pdf/reports/annual/2014-bhs-network-development.pdf

Arizona Medicaid Managed Care Program: Behavioral Health Benefits1. Arizona Health Care Cost Containment System. (2014, August 25). Arizona Health Care Cost Containment System. Retrieved September


Medicaid Managed Care Program: SMI Populations1. Arizona Health Care Cost Containment System. (2014, August 25). Arizona Health Care Cost Containment System. Retrieved September


2. United State Government. (2014, June 23). Federal Register Federal Register §440.315 Exempt individuals. Retrieved July 1, 2014 from http://www.ecfr.gov/cgi-bin/text-idx?SID=bf8c9a15d9868d4dd8eea9e9198a6a7d&node=42:4.0.1.1.9&rgn=div5

Sources

35


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http://www.azdhs.gov/bhs/pdf/reports/annual/2014-bhs-network-development.pdf



http://www.ecfr.gov/cgi-bin/text-idx?SID=bf8c9a15d9868d4dd8eea9e9198a6a7d&node=42:4.0.1.1.9&rgn=div5



Medicaid Managed Care Program: Maricopa County 1. Arizona Health Care Cost Containment System. (2014, April). Mercy Maricopa Integrated Care (MMIC) Contract. Retrieved September 14,

2014 from http://www.azdhs.gov/bhs/contracts/mmic/index.htm2. Mercy Maricopa. (2014). Mercy Maricopa Provider Manual. Retrieved September 14, 2014 from

http://www.mercymaricopa.org/providers/resources/manual

11. Arizona Medicaid Medical & Health Home Initiatives1. Arizona Health Care Cost Containment System. (2011, July). Federal Activities. Retrieved September 14, 2014 from

http://www.azahcccs.gov/reporting/federal/legislation.aspx2. OPEN MINDs Weekly News Wire. (2014, May 5). 27 States With Medicaid Health Homes Initiatives; Over 1,000,000 Complex Consumers

Enrolled As Of March 2014. Retrieved September 14, 2014 from http://www.openminds.com/market-intelligence/news/27-states-medicaid-health-homes-initiatives-1000000-complex-consumers-enrolled-march-2014.htm

12. Arizona State Mental Health & Addiction Treatment Department Organization Chart1. Arizona Department of Health Services. (2014, April 24). Arizona Department of Health Services Agency. Retrieved September 14, 2014

from http://www.azdhs.gov/diro/documents/adhs-org-chart.pdf

13. Arizona State Mental Health & Addiction Treatment Department Governance1. Arizona Department of Health Services. (2014, April 24). Arizona Department of Health Services Agency. Retrieved September 14, 2014

from http://www.azdhs.gov/diro/documents/adhs-org-chart.pdf

Sources

36

http://www.azdhs.gov/bhs/contracts/mmic/index.htm

http://www.mercymaricopa.org/providers/resources/manual

http://www.azahcccs.gov/reporting/federal/legislation.aspx

http://www.openminds.com/market-intelligence/news/27-states-medicaid-health-homes-initiatives-1000000-complex-consumers-enrolled-march-2014.htm

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http://www.azdhs.gov/diro/documents/adhs-org-chart.pdf



14. Arizona State Psychiatric Institutions1. Arizona Division of Behavioral Health Services. (2013, December). Arizona Department of Health Services Division of Behavioral Health

Services Annual Report FY2013. Retrieved September 14, 2014 from http://www.azdhs.gov/bhs/pdf/reports/annual/2013-dbhs-azsh-annual-report.pdf

15. Arizona Accountable Care Organizations (ACOs)• OPEN MINDS Database

16. Arizona Health Care Reform Initiatives1. Centers for Medicaid and Medicare Services. (2014, April). State Medicaid and CHIP Income Eligibility Standards. Retrieved September 14,

2014 from http://www.medicaid.gov/AffordableCareAct/Medicaid-Moving-Forward-2014/Downloads/Medicaid-and-CHIP-Eligibility-Levels-Table.pdf

2. State of Arizona. (2013). House Bill 2010. Retrieved September 14, 2014 from http://www.azleg.gov//FormatDocument.asp?inDoc=/legtext/51leg/1s/laws/0010.htm&Session_ID=111

17. Arizona Health Insurance Marketplace Plans1. Thierer, C. (2014, June 20). QHP Landscape Individual Market Medical. Retrieved September 14, 2014 from

https://data.healthcare.gov/dataset/QHP-Landscape-Individual-Market-Medical/b8in-sz6k2. Thierer, C. (2014, June 20). QHP Landscape SHOP Market Medical. Retrieved September 14, 2014 from


18. Arizona Essential Health Benefit Benchmark Plan 1. State of Arizona. Arizona EHB Benchmark Plan. Retrieved September 14, 2014 from http://www.cms.gov/CCIIO/Resources/Data-

Resources/Downloads/arizona-ehb-benchmark-plan.pdf2. State of Arizona. Arizona EHB Benchmark Plan. Retrieved September 14, 2014 from http://www.cms.gov/CCIIO/Resources/Data-

Resources/Downloads/arizona-ehb-benchmark-plan.pdf

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37

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http://www.medicaid.gov/AffordableCareAct/Medicaid-Moving-Forward-2014/Downloads/Medicaid-and-CHIP-Eligibility-Levels-Table.pdf

http://www.azleg.gov/FormatDocument.asp?inDoc=/legtext/51leg/1s/laws/0010.htm&Session_ID=111

https://data.healthcare.gov/dataset/QHP-Landscape-Individual-Market-Medical/b8in-sz6k


http://www.cms.gov/CCIIO/Resources/Data-Resources/Downloads/arizona-ehb-benchmark-plan.pdf

http://www.cms.gov/CCIIO/Resources/Data-Resources/Downloads/arizona-ehb-benchmark-plan.pdf

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