KINGMAN — A healthcare committee met again Tuesday to discuss the rollout of a new integrated health care plan.
The five-person Arizona Healthcare Accountability Committee met at the Kingman Regional Medical Center. The committee, which meets quarterly, was formed in January by District 5 Sup. Lois Wakimoto. The next meeting is scheduled for January 2019 in Lake Havasu City.
The round-table discussion dealt with the entry of Care 1st Health Plan Arizona, which replaced United HealthCare as one of two providers for county residents on the Arizona Health Care Cost Containment System. Steward Health Choice Arizona is the other provider for Mohave County residents.
AHCCCS Assistant Deputy Director Jamie Snyder said about 1.5 million of the 1.9 million state residents on AHCCCS Complete Care have transitioned to the new healthcare plan with Care 1st.
Wakimoto, the committee’s chair, said the committee was formed to work out issues with the Care 1st Health Plan. Care 1st and Steward Health Choice were awarded a contract in March to provide physical and behavioral healthcare to the five counties in northern Arizona.
Steward Health Choice Vice President Pat Hansen gave a brief presentation of the provider’s statistics including prior authorization requests, reimbursement services, call volume of members and providers, pharmacy management and site visits.
Arizona State Rep. Regina Cobb questioned the notification process for people who need to go into a hospital as an inpatient from the emergency room on weekends if there isn’t anyone from the healthcare provider working on weekends. Notifications to the provider must be received within 48 hours.
Cobb, who is on the committee, asked if the providers could streamline their forms, requesting that the providers follow specific guidelines. They have been given too much latitude in the past, Cobb said.
Other committee members include Arizona State Sen. Sonny Borrelli, Mardi Benedict and private attorney D’Arcy Downs-Vollbracht. Benedict, the committee’s secretary, said the committee and its minutes are on social media including Facebook, Twitter and Instagram.
Another issue is there are few specialists in the area, especially in podiatry, who take AHCCCS patients because of the lack of payments. Wakimoto added there are no podiatry specialists in Bullhead City and only a few in Kingman and Lake Havasu City. Another problem is AHCCCS members don’t notify their provider that they have Medicaid as a secondary insurance.
Another issue is healthcare providers contracting out to either of the two laboratories, Sonora Quest or Lab Corp. Other issues include authorizations for payment for treatment by radiologists and pediatric special needs care.