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Medical Director Update Autism Spectrum Disorder Prescription Drug Misuse/Abuse High need high cost Out of state provider registration 1 Reaching across.

Published byAdela Griffin Modified over 9 years ago

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Presentation on theme: "Medical Director Update Autism Spectrum Disorder Prescription Drug Misuse/Abuse High need high cost Out of state provider registration 1 Reaching across."— Presentation transcript:

1 Medical Director Update Autism Spectrum Disorder Prescription Drug Misuse/Abuse High need high cost Out of state provider registration 1 Reaching across Arizona to provide comprehensive quality health care for those in need

2 ASD: AHCCCS Update Governor’s Office Letter 4-14-15 forming The ASD Advisory Committee AHCCCS utilizing St. Luke’s Health Initiative for facilitation 2 Reaching across Arizona to provide comprehensive quality health care for those in need

3 ASD Advisory Committee: Health Plan and RBHA participants Dr. Rene Bartos (MCP) Dr. Don Fowls (MMIC) Dr. Theresa Courtney (DDD) Mary Jo Gregory (NARBHA) Dr. Leslie Paulus (United Health Care) Terry Stevens (Cenpatico) 3 Reaching across Arizona to provide comprehensive quality health care for those in need

4 ASD: AHCCCS Update AHCCCS PIP to increase use of developmental screening being finalized and will be submitted to health plans for feedback 4 Reaching across Arizona to provide comprehensive quality health care for those in need

5 Leverage Statewide Strategies for Rx Misuse/Abuse within Medicaid System Standardize patient review and restriction program (PRR) criteria o Draft policy distributed and reviewed through P&T o Scheduled for finalization at 7-21-15 P&T Increase use of CSPMP o AHCCCS PIP methodology being finalized for distribution for health plan input Reevaluating QL and PA requirements for controlled rx on MRPDL Enhance Referral to Treatment o DBHS workgroup with health plans/RBHAs 5 Reaching across Arizona to provide comprehensive quality health care for those in need

6 High Need High Cost Initiative AHCCCS met with health plans and RBHAs on 4-22 and 5-12 Developing standardized criteria for member selection o ED visits, hospital admissions, and expenditures o Special considerations for distinct populations (ie, AIHP, DDD, CRS, and CMDP) 6 Reaching across Arizona to provide comprehensive quality health care for those in need

7 Out of State Provider Registration AHCCCS is developing a streamlined registration process for out-of-state providers who: Meet a critical AHCCCS need; and Have been enrolled/screened with/by Medicare or another state Medicaid agency 7 Reaching across Arizona to provide comprehensive quality health care for those in need

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