House of Representatives

SB 1148

AHCCCS; behavioral health services

Sponsors: Senators Gerard, Nichols

DPA	Committee on Health
X	Caucus and COW
	As Passed the House

SB 1148 makes changes to the eligibility process and the Department of Health Services behavioral health grievance and appeals process.

History

Current law stipulates that the Department of Health Services (DHS) must require all Regional Behavioral Health Authorities (RBHAs) to establish a grievances and appeals process for recipients of behavioral health services as well as provide services. The law further states that RBHAs as well as service providers and service recipients who have already exhausted the RHBA process may appeal to the DHS grievance and appeal process. SB 1148 removes language regarding the exhaustion of the RHBA process, making it permissible for service providers and individuals receiving/requesting services to directly utilize the DHS grievance and appeal process.

Currently, recipients and providers of behavioral health services who are eligible for the state’s Medicaid program (Arizona Health Care Cost Containment System-AHCCCS), shall be notified that after appealing to DHS, the individual or provider may appeal to AHCCCS. SB 1148 permits individuals eligible for AHCCCS as well as service providers to appeal decisions directly to AHCCCS.

Provisions

· Requires a person who receives behavioral health services from DHS and who has not been determined eligible for Title XIX (Medicaid) or Title XXI (State Children’s Health Insurance Program-[CHIP]Kids Care) to comply annually with the eligibility determination process.

· Expands the applicants available to be eligible to receive behavioral health services and requires the applicant to cooperate fully with the eligibility determination process.

· Requires DES and AHCCCS to promptly inform DHS of applications denied based on failure to cooperate with the eligibility determination process.

· Prohibits any person from being entitled to any particular services that are subject to legislative appropriation.

· Authorizes behavioral health service clients and service providers to file appeals directly to DHS.

· Requires regional behavioral health authorities to notify clients of their right to appeal a decision directly to the AHCCCS administration.

SB 1148 was amended in the Health Committee as follows:

· Reinserts stricken language pertaining to the exhaustion of a RBHA grievance and appeal process [Page 2, line 18 and 19, and line 28]

· Allows individuals eligible for behavioral health services through AHCCCS, who are appealing the denial, reduction, termination or suspension of Title XIX [Medicaid] behavioral health services appeal directly to AHCCCS for an expedited hearing.

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45th Legislature

First Regular Session 2 March 20, 2001

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