House of Representatives

SB 1148

AHCCCS; behavioral health services

Sponsors: Senators Gerard, Nichols

 

DPA

Committee on Health

DPA

Caucus and COW

 

X

As Transmitted to the Governor

 

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 service providers.  The law further states that RBHAs and service providers and recipients who have already exhausted the RHBA process may appeal to the DHS grievance and appeal process.  SB 1148 makes it permissible for individuals eligible for behavioral health services through AHCCCS (Medicaid) to appeal directly to AHCCCS, regardless of the appeals processes of DHS or the contracting RBHAs.       

 

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.

 

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

 

·                      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                                                               May 2, 2001

 

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