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What’s happening
The Arizona Health Care Cost Containment System (AHCCCS) notified Mercy Care late Tuesday, September 10, that it intends to extend the existing ALTCS E/PD contracts for one year, until September 30, 2025.
Mercy Care would like to thank the countless number of individuals including members, providers, long term care experts, and community advocates who used their voices and wrote hundreds of messages to AHCCCS and government officials, in response to AHCCCS’ approach and decisions surrounding the ALTCS RFP process, awards, transition process and director designee’s decision.
Mercy Care is continuing to explore options regarding next steps for our appeal in the ALTCS E/PD procurement process. We will continue advocating for what is in the best interest of members, their families, our providers, and other key stakeholders.
As a reminder, Mercy Care remains an AHCCCS health plan. This activity does not have any effect on our ACC-RBHA, ACC-RBHA with SMI, DDD, Mercy Care Advantage or DCS-CHP contracts.
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.
Mercy Care has achieved LTSS Distinction from the National Committee on Quality Assurance (NCQA).
LTSS is an abbreviation for Long Term Services and Supports. NCQA’s LTSS Distinction supports health plans that provide managed health services and coordinate social services for members eligible for these benefits.
Achieving NCQA LTSS Distinction by 10/1/2024 is a requirement of health plans contracted with the Arizona Long Term Care System (ALTCS), including Mercy Care.
NCQA is a private, non-profit organization dedicated to improving health care quality. Learn more at www.ncqa.org.
We're grateful to NCQA for their collaboration and we congratulate Mercy Care's colleagues, especially those who directly serve our ALTCS members, for their dedication to this effort.
On August 9, we received the Administrative Law Judge’s (ALJ) recommended decision to AHCCCS on our RFP protest. The ALJ recommended the appeal be granted, the procurement be cancelled, and a new Request for Proposal (RFP) issued. This is not a final decision on the protest - it is only a recommendation.
AHCCCS now has until September 9 to issue a final decision.
On August 13, AHCCCS announced it is pausing member transition activities related to the ALTCS E/PD contract awards. This means that all work related to member transition activities for the new contracts stopped immediately and that members will remain with their current ALTCS health plan “for the foreseeable future.”
Mercy Care has been a strong partner to AHCCCS since 1985. We’ve served members and providers as an ALTCS contractor since 2000. For nearly 25 years, we’ve operated a quality program, focused on delivering access to high-quality care for our ALTCS members. We’ve transformed the health care delivery system for members who are eligible for long-term care by helping them remain in the care setting of their choice, while getting the services and supports they need to live their healthiest life and achieve their full potential.
Mercy Care is ready and able to continue serving ALTCS members and families.
To all those who have advocated for ALTCS members in this matter, we’re grateful for your continued support.
It's important to note that this contract award does not impact Mercy Care’s other lines of business, including Mercy Care ACC-RBHA, Mercy Care Developmental Disabilities, Mercy Care Advantage and Mercy Care DCS CHP.
See this announcement from AHCCCS for an important update on Mercy Care’s appeal of the ALTCS E/PD contract awards.
An important update for our community on Mercy Care’s appeal of the ALTCS E/PD contract awards. More information on the status of the ALTCS RFP can be found on AHCCCS’s website .
This week, Mercy Care learned our appeal will be heard by an Administrative Law Judge (“ALJ”) with the Arizona Office of Administrative Hearings between March 25 and April 15. The AHCCCS protest process includes many steps and an administrative hearing is a next step in this process. Following the hearing, the ALJ will recommend a decision to the AHCCCS Director.
Our position remains that the initial outcome of the ALTCS E/PD RFP is not in the best interest of the state. This proposed transition is an unjustified disruption to thousands of elderly, physically disabled and medically frail people served by Mercy Care, who has proven success in serving ALTCS members, while also reducing members’ choice of health plan, and ultimately disrupting their care delivery.
We continue to be optimistic about the possible outcome and continue to explore all options, including the possibility to stay (pause) the contract award (to include any and all transition or implementation activities) until Mercy Care’s protest has been fully and finally adjudicated.
Thank you for your continued support.
It's important to note that this contract award does not impact Mercy Care’s other lines of business, including Mercy Care ACC-RBHA, Mercy Care Developmental Disabilities, Mercy Care Advantage and Mercy Care DCS CHP.
On Wednesday, Feb. 7, Mercy Care filed an appeal with the director of AHCCCS which is the next step in this process. As anticipated, the AHCCCS Procurement Officer denied all protests on Feb 2. The AHCCCS protest process includes many steps and Mercy Care’s appeal to the AHCCCS director is the next step in this process.
We’ll continue to share important updates. More information on the status of the ALTCS RFP can be found on AHCCCS’s website.
For 23 years, Mercy Care has delivered access to innovative, member-focused care that has resulted in excellent health outcomes for thousands of ALTCS E/PD members.
Mercy Care should continue serving ALTCS E/PD members and their families who rely on us to help them get the care and services they need while honoring member choice of ALTCS E/PD health plans. The outpouring of stakeholder feedback proves this is in the “best interest of the state.”
As we’ve said previously, we sincerely appreciate the outpouring of support from members, families, providers, advocates, community organizations and other key stakeholders since the announcement on December 1. We are honored to work alongside you.
It's important to note that this contract award does not impact Mercy Care’s other lines of business, including Mercy Care ACC-RBHA, Mercy Care Developmental Disabilities, Mercy Care Advantage and Mercy Care DCS CHP.
Today, Feb. 2, the AHCCCS Chief Procurement Officer denied Mercy Care’s protest of the ALTCS E/PD contract awards.
We are reviewing AHCCCS’s decision and will continue to share important updates. More information on the status of the ALTCS RFP can be found on AHCCCS’s website.
AHCCCS has a stated objective in the ALTCS RFP to do what is in the “best interest of the state.” This decision involves an unnecessary disruption of thousands of elderly, physically disabled and medically frail people from Mercy Care, who has proven success in serving our ALTCS members with a strong network, quality results and member and provider satisfaction results. This decision will also reduce member choice of health plans in the state of Arizona.
We extend our sincere appreciation for the outpouring of support from members, families, providers, and key stakeholders since the announcement on December 1. We continue to be humbled by the community support and are honored to work alongside you.
It's important to note that this contract award does not impact Mercy Care’s other lines of business, including Mercy Care ACC-RBHA, Mercy Care Developmental Disabilities, Mercy Care Advantage and Mercy Care DCS CHP.
Today, Mercy Care filed a protest in response to the AHCCCS announcement for ALTCS contract awards effective October 1, 2024.
We will continue to share important updates with you. Additional information on the status of the ALTCS RFP can be found on AHCCCS’s website here: YH24-0001 – ALTCS E/PD BIDDERS’ LIBRARY.
We’ve been deeply touched by the outpouring of support from members, families, providers, and key stakeholders impacted by this decision since the announcement on December 1. We are grateful to all who share in our unwavering commitment to the most vulnerable people in the state.
It is important to know that this activity does not impact Mercy Care’s other lines of business, including Mercy Care ACC-RBHA, Mercy Care Developmental Disabilities, Mercy Care Advantage, and Mercy Care DCS CHP.
On Friday, December 1st, Mercy Care was notified that we were not awarded a contract for the Arizona Long Term Care System (ALTCS) Elderly and Physically Disabled (E/PD) services by the Arizona Health Care Cost Containment System (AHCCCS). ALTCS E/PD is health benefits coverage for individuals who are age 65 or older, or who have a disability, and who require nursing facility level of care. Individuals in the ALTCS program are some of the most vulnerable people in the State.
As a local, not-for-profit, provider-sponsored health plan, Mercy Care and our dedicated, caring and highly qualified employees and providers have been effectively delivering critical services to many families in Arizona for ALTCS E/PD for 23 years. We are extremely heartened by the overwhelming support we have received from the members, families, providers and stakeholders we serve since the decision was announced Friday. Thank you to those who have reached out and expressed your support. Please know we are incredibly grateful to serve this community, invest in this community, and provide the best care possible to Arizona families.
We are currently reviewing our options to determine potential next steps in this process before commenting further on this disappointing outcome.
It is important to know that this decision does not impact Mercy Care’s other lines of business, including Mercy Care ACC-RBHA, Mercy Care Developmental Disabilities, Mercy Care Advantage, and Mercy Care DCS CHP.
Thank you for your support.
Statewide crisis phone line vendor selected
As part of the AHCCCS Complete Care Competitive Contract expansion, the ACC-RBHA contractors, Mercy Care, Care1st and Arizona Complete Health-Complete Care Plan (AzCH-CCP), have jointly selected a single statewide crisis phone vendor to operate Arizona’s 24/7/365 behavioral health crisis phone lines effective 10/01/2022.
Solari was selected to enter into a provider contract with each of the three RBHA contractors.
Solari was selected after a joint Invitation to Respond process. The Invitation to Respond was issued February 18, after gathering public input in January and February 2022. Public input was provided through online surveys and virtual community listening sessions in English and Spanish.
Work to combat sex trafficking continues in Tucson despite reduced resources
Tucson agencies no longer do proactive undercover work to find sex traffickers, and the Police Department now has only one detective reviewing and investigating suspected cases of people being forced into sex work. Much of that work is now done by federal agents with Homeland Security Investigations.
But local and federal officials say an October rescue of a 14-year-old victim — who said she was sexually exploited in four states — is among other examples showing they are still working together to target suspects and crack cases, despite a recent reduction in funding and resources.
Executive director Marie Fordnoy of the Children’s Advocacy Center of Southern Arizona said the way investigations are conducted makes a difference in the level of trauma a person experiences.
“We use an evidence-based model that gets the story from them while minimizing their trauma,” Fordnoy said of the center’s interview process. “When you provide these services in an advocacy center, research shows the victim is more likely to get follow-up medical care and follow-up mental health services.”
Another member of the collaborative is Mercy Care, a local nonprofit, Medicaid managed-care health plan.
“Children in foster care have a higher risk of becoming trafficking victims, and through our partnership with the Department of Child Safety, we’re responsible statewide for the health and wellness of these children,” Mercy Care project manager Amber Divens, who works with the Southern Arizona Human Trafficking Collaborative, said in an email to the Star.
“We want to make sure that youth who have been trafficked have immediate access to the physical and mental health care services they need.”
Read the full story at the Arizona Daily Star.