“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System September 19, 2012 AHCCCS Update Meeting DUAL ELIGIBLE INITIATIVES  Part D Data  Dual Demo Update  D-SNP Contracting Policy

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 2 PART D DATA  CMS is allowing States to request Part D Prescription Drug Event data for care coordination purposes  AHCCCS plans to share data with members’ Medicaid plan  As a downstream entity, all plans receiving data must sign DUA Amendment and report to AHCCCS how information is being used

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 3 DUAL DEMONSTRATION UPDATE  Proposal was submitted to CMS on May 31st  Still working on major issues  Rates/Supplemental Benefits  Enrollment Opt-out to Original FFS Medicare only Monthly Demo plan change (including Medicaid) Annual enrollment period  Network/Contracting

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 4 DEMO UPDATE - CONTRACTING  Demo timelines anticipated to follow MA  Notice of Intent due beginning of November  Application due end of February  Application includes Demo network  All contracts must specify Demo – Not just SNP/MA/AHCCCS  Confirmation from CMS okay to say Demo or SNP  Do not have rates  Contract awards not until after submission deadline

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 5 TIMELINE & POPULATIONS  January 1, 2014 statewide implementation  3 populations ALTCS E/PD: 21,000 Acute members with Serious Mental Illness in Maricopa County: 7,000 Acute: 77,000  All ALTCS E/PD and Acute members will be passively enrolled – From Medicare Advantage plans and Original FFS Medicare

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 6 HEALTH PLAN SELECTION  ALTCS E/PD: Use existing ALTCS contractors  Members with Serious Mental Illness in Maricopa County: Maricopa RBHA required to be Demo plan (or D-SNP if Demo does not move forward)  Acute: Plans selected through RFP - must become Demo plan (or D-SNP if Demo does not move forward)  **No dual only plans – Must be AHCCCS plan

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 7 DEMO NEXT STEPS  Continue discussions with CMS around key issues  Fall Begin negotiations for contract between State and CMS (MOU)  November 2012 – Target to finalize MOU  Spring 2013 – 3-way contracts signed between State, CMS, and health plans  Summer 2013 – Readiness reviews conducted  Fall 2013 – Member/provider education and outreach  January 1, Implementation

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment System 8 D-SNP POLICY  Effective April 1, 2012  2013: Worked with all current D-SNPs  2014 and Beyond: Will not sign MIPPA contracts with D-SNPs outside of Medicaid contracts  Exceptions may be DD and Maricopa RBHA  Many D-SNPs may need to change D-SNP subset to match Medicaid contracts  Review information for submitting Service Area Expansion or changing subset