DCS Comprehensive Health Plan

Member Information Requirement

Statement/Purpose

DCS CHP ends health coverage for youth who no longer meet the enrollment qualifications set forth in A.R.S. § 8-512.

Definitions

Arizona Health Care Cost Containment System (AHCCCS): State’s program for medical assistance available under Title XIX of the Social Security Act and state public insurance statutes, A.R.S. Title 36, Chapter 29.

DCS CHP and its contracted MCO: the program authorized by A.R.S. § 8-512.

Health-e-Arizona PLUS: A system developed by AHCCCS and the Department of Economic Security (DES) used to apply for AHCCCS Health Insurance, KidsCare, Nutrition Assistance and Cash Assistance benefits and to connect to the Federal Insurance Marketplace.

Title XIX: The section of the Social Security Act which describes the Medicaid program's coverage for eligible persons, (i.e., medically indigent). Title 19 benefits are provided through the Medicaid federal entitlement program; benefits are delivered in Arizona through the Arizona Health Care Cost Containment System.

Policy

The Department of Child Safety Comprehensive Health Plan, ensures that eligibility for health care services provided by DCS CHP is ended/closed when an individual no longer meets the definition of out-of-home care as defined in A.R.S. § 8-512.

Procedure

DCS CHP receives disenrollment notification information from a variety of sources including, but not limited to:

• DCS Child Welfare Case Management System (Guardian) records and Advanced Find reports;

• AHCCCS Prepaid Medical Management Information System (PMMIS) 834 transactions enrollment and disenrollment roster;

• DCS CHP Disenrollment Information Form

• Email correspondence; and

• Health-e-Arizona PLUS (HEA)

DCS CHP utilizes these notifications to initiate timely member disenrollment. DCS CHP conducts follow up activities to ensure the disenrollment has been processed in DCS data systems, HEA and AHCCCS.