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Arizona Complete Health-Complete Care Plan (Medicaid) December 2024 Provider Manual Update is Now Available

Date: 12/04/24

The Arizona Complete Health-Complete Care Plan (Medicaid) Provider Manual has been updated and is available on our website.

The table below outlines the sections revised for December 2024. We encourage you to review.

 
SectionTitleRevision
2.3Family Planning for Title XIX/XXI Adults with SMIAdded guideline on syphilis screening.
2.4.3A Well-Child Exam Basic ElementsAdded guideline on syphilis screening.
4.3.13Further Consideration for Denials of Requested ServicesAdded language regarding the use of licensed psychologists as peer to peer outpatient review.
6.1Introduction and ProcessesUpdated list of Individual Practitioners and Organizational Providers. 
8.22.2Identifying Other Health InsuranceUpdated language regarding how providers should identify the existence of potentially liable parties and included link to AHCCCS website.
8.22.7Medicaid Eligible Persons with Medicare Part A and Part B or Other InsuranceAdded language regarding provider to identify if members are enrolled in insurance other than Medicare and Health Plan reimbursement responsibility when a member has other insurance. 
13.12.1General Requirements (Special Assistance)Added language regarding identification and notification of members with an SMI Determination. 
13.12.2Persons Qualified to Make a Special Assistance DeterminationAdded language specifying persons/roles who are qualified to screen and make the Special Assistance Determination. 
13.12.4Documentation (Special Assistance) Changes made throughout, please review in full. 
13.12.5Notification Requirements to the Office of Human RightsChanges made throughout, please review in full. 
13.12.6Members No Longer in Need of Special AssistanceChanges made throughout, please review in fulChanges made throughout, please review in full. l. 
13.12.7Requirements to Help Ensure the Provision of Special AssistanceChanges made throughout, please review in full. 
13.12.8Integrated Health Home Reporting Requirements (Special Assistance)Changes made throughout, please review in full. 
13.12.10Other Procedures (Special Assistance)Changes made throughout, please reviewChanges made throughout, please review in full. 
13.12.11Transfer of a Special Assistance MemberChanges made throughout, please reviewChanges made throughout, please review in full. 
16.8Relias Learning Management System (LMS)Revised the list regarding exceptions.
16.14.9Peer Recovery Support Specialist and Certified Family Support Partner ReportingRevised to include attachment B and due date.
19PROVIDER MANUAL FORMS & ATTACHMENTSRemoved attachment for 3.11.1.

To request a copy of the Medicaid Provider Manual, please email us. We will respond to your request within three business days.

If you have questions, please contact your Provider Engagement Specialist. If you need your assigned Provider Engagement