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AHCCCS CMO Update

Stay informed on AHCCCS CMO's efforts to provide comprehensive and quality health care across Arizona. Get updates on pharmacy, autism spectrum disorder, BH service needs for children in foster care, and more.

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AHCCCS CMO Update

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  1. AHCCCS CMO Update Reaching across Arizona to provide comprehensive quality health care for those in need Pharmacy ASD Advisory Committee BH Service Needs for Children in Foster Care

  2. Pharmacy Reaching across Arizona to provide comprehensive quality health care for those in need

  3. Summary of Supplemental Rebate to Date • 14 drug classes since Jan 2015 • Represents ~11% of available classes and ~22% of total pharmacy spend Reaching across Arizona to provide comprehensive quality health care for those in need

  4. Supplemental Rebate Classes for AHCCCS Preferred Drug Lists Reaching across Arizona to provide comprehensive quality health care for those in need • Hepatitis C Virus (January 2015) • Epinephrine, Injectable (November 2015) • Cytokine and CAM Antagonists (November 2015) • Growth hormone (November 2015) • Inhaled Antibiotics (November 2015) • Inhaled Glucocorticoids (February 2016) • Substance Use Disorder (May 2016) • Hypoglycemic Agents: Insulin and Related Agents (May 2016) • Hypoglycemic Agents: Incretin Mimetics/Enhancers (May 2016) • Chronic Obstructive Pulmonary Disease (May 2016) • Atypical Antipsychotics (August 2016) • Stimulants and Related Agents (August 2016) • Pancreatic Enzymes (August 2016) • Anticoagulants (August 2016) • Long-acting narcotics (Oct 2016)

  5. Supplemental rebates • AHCCCS will notbe adding any additional classes for review at this time • Capitation rates • AHCCCS actuaries conducting a special detailed analysis • If this analysis determines that a further capitation rate adjustment is warranted, we will update the capitation rates mid-cycle Reaching across Arizona to provide comprehensive quality health care for those in need

  6. Opioids Pharmacy Directors Meeting 9/23/16 • Limit first fill to 10 days • MED at POS to guide interventions • Co-prescribing naloxone to prevent OD • CSPMP check for pregnant members Reaching across Arizona to provide comprehensive quality health care for those in need

  7. HCV DAA • Updated draft policy distributed to pharmacy and medical directors • Currently out for public comment • Anticipated effective date: 10/1/16 Reaching across Arizona to provide comprehensive quality health care for those in need

  8. Autism Spectrum Disorder (ASD) Reaching across Arizona to provide comprehensive quality health care for those in need

  9. ASD • Interim solution update • Long-term solution remains: integration 10/1/18 • BCBA provider type going “live” 10/1/16 • BCBA code set released 6/2016 being updated • Streamlined PCP referral to Specialized ASD Diagnosing Provider • Next GO ASD Advisory Committee 9-28-16 Reaching across Arizona to provide comprehensive quality health care for those in need

  10. BH Service Needs for Children in Foster Care Reaching across Arizona to provide comprehensive quality health care for those in need

  11. Updates • HB2442 • CMDP Dashboard finalization • Forums for implementation • Monthly RBHA/CRS Meetings • OIFA-led meetings with foster, kinship and adoptive families • Monthly CMDP/DCS Meetings • Monthly Operational Meetings Reaching across Arizona to provide comprehensive quality health care for those in need

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