Beginning October 1, Arizona Health Care Cost Containment System will automatically enroll all Acute Care members into their local Regional Behavioral Health Authority (RBHA) or Tribal RBHA (T/RBHA). The plan eliminates the need for a separate administrative enrollment with the T/RBHA (and the associated paperwork) and streamlines the delivery of services, better integrate physical & behavioral health care.
The T/RBHAs will also assume financial responsibility for behavioral health services immediately upon enrollment with AHCCCS, including: 1) any behavioral health services provided during the allowable time period after the application for AHCCCS has been submitted and the individual is actually enrolled with AHCCS (called Prior Period Coverage); and 2) the first 72 hours of inpatient emergency behavioral health services. Acute Care AHCCCS contractors will continue to be responsible for all emergency medical services including triage, physician assessment and diagnostic tests.
Why are the Acute Care AHCCCS contractors will continue to be responsible for all emergency medical services including triage, physician assessment and diagnostic tests. Doesn’t the government have any input?
This just means that for anyone who is AHCCCS eligible/enrolled, the acute care physical health plan covers ER visits, rather than the behavioral health system covering those costs. Because we carve-out BH from PH, we need to clarify who is responsible. This does not mean that AHCCCS covers ER visits for everyone…just those who are AHCCCS eligible/enrolled.