Systems Update May 2012

HIPAA 5010 Project Status Key Considerations/Timeline for 7/1/2012 Next Steps

Project Status Wrapping up all 5010 changes per the previously stated timeline Key Milestones for 7/1/2012 full compliance:  11/1/2011 – Programming re-started and Freeze Period began  1/2012 – Coding completes, start internal testing  3/2012 – Begin UAT (external testing)  6/2012 – Complete UAT  7/1/2012 – Implementation in Production and Freeze Period ends

Key Considerations/Timeline for 7/1/2012 To accommodate necessary changes to the PMMIS databases the 2 nd Encounter cycle for June will be cancelled and PMMIS will not be available during this conversion process beginning 6/30 up to a late as 7/4. Last day that plans may submit 4010 and NCPDP non PAH format encounters for AHCCCS processing is 6/7/2012 (before 6:00pm) If 4010 format encounters are received after 6/7/2012 they will be rejected upfront in validation

Key Considerations/Timeline for 7/1/2012, cont. Contractors must also complete all TI corrections to 4010 format encounters prior to 6/7/2012 All Contractors are encouraged to complete their 5010 and NCPDP Encounter testing as soon as possible

Next Steps Post implementation support 30 to 60 days after 7/1 Publish final Companion Documents for all Transactions

ICD10 Proposed CMS Implementation Date Change Revised AHCCCS Project Timeline AHCCCS Project Approach CMS Site Visit Next Steps

Proposed CMS Implementation Date Change “The Department of Health and Human Services (HHS) announced a proposed rule that would delay, from October 1, 2013 to October 1, 2014, the compliance date for the International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).” Comments to proposed Rule due by May 17 th Should be published by September 2012 if approved

Revised AHCCCS Project Timeline Assuming a 10/1/2014 effective date AHCCCS has revised our project milestones as follows:

Revised AHCCCS Project Timeline, cont. Complete Final Review of System ImpactsJuly 2012 Complete Document/Operational ImpactsJuly 2012 Finalize Operational Documentation ChangesOctober 2012 And Policy Remediation Complete Requirements and Design – ReferenceNovember 2012 Complete Requirements and Design – All other January 2013 System Areas PMMIS Code Freeze Begins….February 2013 Freeze Begins..... System Implementation – Reference March 2013 Initial Reference Table LoadsApril 2013 External Testing Begins September 2013 System Implementation – All other SystemSeptember 2013 Areas PMMIS Freeze Ends..... External Testing EndsSeptember 2014 ICD10 Effective DateOctober 2014

AHCCCS Project Approach Native processing including review and remediation of impacted policies and processes Use of GEMS as a points for reference/validation only

CMS Site Visit The CMS team responsible for ICD10 will be onsite in Arizona to conduct a half day Management level overview of interested parties Information as to the specific date/time/location and how to RSVP will be posted on the AHCCCS webpage

Next Steps Finalize System Impacts Finalize Documentation, Policy and Process impacts Begin review and remediation of above impacts Conduct Internal Training Complete the detailed project planning Inventory published GEMS and other related ICD10 documentation Establish parameters for and initiate Contractor milestone reporting

Other Projects Pharmacy Data – Professional and Facility Form Type Focused Encounter Pends and Denials Review Recent Implementations – NEMT Copays; 340B Pharmacy Payments

Pharmacy Data – Professional and Facility Form Type Captured as reported effective 7/1/2012 with the implementation of 5010 changes Specific rule tables outlining reporting requirements are in progress and will be implemented along with related encounter and claims editing for 10/1/ aspxhttp:// aspx

Focused Encounter Pends and Denials Review We have identified a number of opportunities to clarify and or revise current encounter edit logic and related processes The revisions and clarifications will be prioritized for completion between October 2012 and March 2013 Specific details as to the impacted edits and proposed changes will be communicated as they are finalized

Recent Implementations – NEMT Copays; 340B Pharmacy Payments Non-Emergency Transportation Copays (NEMT) - ayments.aspx ayments.aspx 340B Pharmacy Payments – aspx aspx

Technical Consortium Meetings Looking at scheduling for late July, early August watch webpage for more information on date/time/location and how to RSVP