Arkansas PASSE: Provider-led Medicaid Plan

2. Provider-led Arkansas Shared Savings Entity The PASSE Model of Care is a State health plan created to meet the needs of approximately 43,000 Medicaid recipients with complex behavioral health, developmental, or intellectual disabilities. Three PASSEs have formed to manage care for these clients. On March 1, 2019, providers will no longer bill Medicaid for these clients. Provides will instead bill the individual PASSEs. 2/25/2019

3. Who is served by the PASSEs? PASSE Enrollment Population includes only: • Individuals receiving services through DD Waiver • Individuals who are on the DD Waiver Waitlist • Individuals who are in private DD Intermediate Care Facilities • Individuals that have a Behavioral Health Diagnosis and have received an Independent Assessment that determines they need services in Tiers 2 or 3

4. Who are the PASSEs? Arkansas Total Care (also known as ATC INC) www.arkansastotalcare.com | 1-866-282-6280 Empower Healthcare Solutions www.getempowerhealth.com | 1-866-261-1286 Summit Community Care(also known as APC PASSE LLC) www.summitcommunitycare.com | 1-844-405-4295

5. PASSE Functions • This model does not change a person’s eligibility for Medicaid, it changes how these services are paid for. • Each PASSE is required to have available services statewide. • The Passe is similar to an insurance group and covers health care services for its members. • The PASSEs will assume full risk and be responsible for working with members to create and update the Person Centered Services Plan (PCSP) • PASSE will be responsible for paying claims for all medical services covered by Medicaid for passe members • Medicaid enrolled Service Providers will submit claims to the PASSE to which the Medicaid beneficiary has been assigned • A 60 day transition period is required in which all prior authorized Medicaid services will be honored by the member’s passe

6. Member Identification Through PASSE ID Card Clients will be sent a new ID card from his or her PASSE resembling one of these: * Clients need to keep both this new PASSE card and their Medicaid card on hand for appointments.

7. Member Identification Through Provider Portal AR Medicaid Service Providers can access the DXC Provider Portal as of Feb. 15, 2019 to verify Medicaid eligibility and to find out if a client has been assigned to a PASSE and if so which PASSE the client has been assigned to. DHS staff can provide guidance on locating that information in the provider portal by communicating the following steps: 1 First, go to the DXC Provider Portal: https://portal.mmis.arkansas.gov/armedicaid/provider/Home/tabid/135/Default.aspx

8. Member Identification Through Provider Portal(Continued) 2 Enter provider User ID and click "Log in." * Register or create an account if this is your first time logging in.

9. Member Identification Through Provider Portal (Continued) 3 Enter provider Challenge Answer and click "Continue."

10. Member Identification Through Provider Portal (Continued) 4 Enter provider Password and click “Sign in."

11. Member Identification Through Provider Portal (Continued) 5 Click the "Eligibility" tab. Enter the Beneficiary Medicaid ID, Date of Birth, and click "Submit."

12. Member Identification Through Provider Portal (Continued) 6 Scroll down to see the "Managed Care Assignment Details“.

13. Helping Providers Connect to the Member’s PASSE If clients or providers need help, DHS and each PASSE has staff on hand, ready to help. Assistance for Providers: Arkansas Total Care (also known in the system as ATC INC) Empower Healthcare Solutions Summit Community Care (also known in the system as Arkansas Provider Coalition or APC PASSE LLC) 1-866-282-6280 1-855-429-1028 1-844-462-0022

14. Helping Providers Connect to the DHS PASSE Provider Call Center The PASSE Provider Call Center will be staffed with DHS employees who will be able to answer questions or assist providers with issues that cannot be resolved in your call. • DHS PASSE Provider Call Center Line 1-888-889-6451 • Call Center email passe.provider.questions@dhs.arkansas.gov • Call Center hours • Tuesday 2/19/19 through Friday 5/31/19 Monday-Friday 8:00 am-6:00 pm • Call center will be open the first two weekends in March Saturday and Sunday 8:00 am – 8:00 pm

15. Infographic for Providers DHS is distributing a resource that looks like this:

16. What if Clients need help? If clients need help, give them the following numbers: First, ask if they have called their PASSE: If they have questions about services covered, about something they need, or to contact their care coordinator, they should call their PASSE first. Arkansas Total Care Empower Healthcare Solutions Summit Community Care 1-866-282-6280 1-866-261-1286 1-844-405-4295 If they just need information or want to switch PASSEs, they can call: PASSE Beneficiary Support 1-833-402-0672

17. What if Clients need help? If clients need help, give them the following numbers: If they called their PASSE and still have an issue: The Ombudsman Office handles any concerns that PASSE members may bring to its attention. A client might want to call: • If their care coordinator can't connect them with the services they need • If a care coordinator hasn't contacted them at least once per month. • If they have concerns their PASSE can't help with. PASSE Ombudsman Office 1-844-843-7351

18. What if Clients need help? DHS is distributing a resource that looks like this:

19. What about ForeverCare’s Clients?

20. For the most updated information, visit the PASSE website www.passe.arkansas.gov