Fraud and Abuse:

AHCCCS has recently published to it's website an e-learning seminar "Fraud Awareness for Providers" that discusses provider and member fraud. We are encouraging Providers, PHS staff and members to visit the site and watch the seminar. The link is: http://www.azahcccs.gov/commercial/default.aspx

Please share this resource with your staff and let us know if you have questions or need additional resources.

Bridgeway Medicare Advantage Plan:

Don't forget, PHS has an affiliation with Bridgeway Health Solutions. If you are looking for a new Medicare Advantage Plan, please call PHS Member Services at 243-8060 or contact your case manager directly.

Changes to Acute and ALTCS Benefits:

Effective October 1, 2010, due to huge budget problems and more people being added to the Medicaid Program, AHCCCS will no longer pay for certain medical care for anyone who is 21 years or older.

For more information go to this link:

http://www.azahcccs.gov/reporting/legislation/2010/BenefitChanges.aspx

Obligation to Screen for Federal Exclusions:

Important reminder, as a registered provider with the AHCCCS Administration, providers are obligated under 42 C.F.R. 1001.1901(b) to screen all employees, contractors and/or subcontractors to determine whether any of them have been excluded from participation in Federal health care programs. You can search the HHS-OIG website, at no cost, by the names of any individuals or entities. The database is called LEIE and it can be accessed at the following link:

http://www.oig.hhs.gov/fraud/exclusions.asp

AHCCCS Co-Pay Information: You can find the details about co-pays for some eligibility groups beginning October 1, 2010 at this link:

http://azahcccs.gov/commercial/providerbilling.copayments.aspx

For Providers-A New PHS Publication has been released on Cultural Competence and Cultural Diversity for Health Care Providers. If you would like a bound copy please call Provider Services at 243-8500. You are welcome to use these materials for training and education purposes.

Cultural Competency & Cultural Diversity For Health Care Providers