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Bulletins and Newsletters

AHCCCS Guidelines for ROPA Care Providers


Referring, ordering, prescribing or attending (ROPA) care providers will be required to register with AHCCCS for claims reimbursement and UnitedHealthcare Community Plan of Arizona has implemented this requirement into our claims processing guidelines. 

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Review these alerts, bulletins and newsletters to stay up to date on news, policy changes and other issues important to your practice.

Alerts, Bulletins and News

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  • 11.06.2024 - Training Announcement: Preventing Veteran Suicide: Strategies and Resources for Community-Based Health Care Professionals.
    When: Wednesday, November 20, 2024, from 11-12 Arizona time.
    Click HERE to register for this live training and other on demand training opportunities!
  • 09.18.2024- Revised AHCCCS Minimum Subcontract Provisions effective October 1, 2024
  • 09.06.2024 - Arizona Health Care Cost Containment System (AHCCCS) has approved the use of Certified Doula Services effective October 1, 2024. Doula’s provide continuous physical, emotional, and information support to people before, during and shortly after childbirth. FAQ’s and additional details can be found at: Doula Providers (azahcccs.gov).
  • 08.23.2024 - Impact of Medications on risk of heat-related illness
  • 08.13.2024- AHCCCS-ATD WFD Executive Leadership Accelerator Series Officially Launches! - AHCCCS Launches Workforce Development Executive Leadership Accelerator Series for Senior Executives at Home and Community Based Services (HCBS) Provider Organizations.

    AHCCCS has teamed with the Association for Talent Development (ATD)—the foremost global expert in workplace learning and development—to provide a leadership event designed exclusively for senior executives to help healthcare business leaders align organizational culture with workforce capability. 

    Click this link for more information.

  • 08.12.2024 - PCP Reminder - VFC 2024 re-enrollment instruction guide - UnitedHealthcare Community Plan providers with members younger than 19 years of age assigned must participate in the Vaccines for Children (VFC) program. Re-enrollment ends Aug 31, 2024. If your location is inactivated from the VFC program, your members may be reassigned to another VFC registered PCP.
  • 08.06.2024 - Important update from AHCCCS on VFC Vaccines Coding and Reimbursement
  • 07.29.2024 - Effective August 1st, branded Humira will be moved to non-preferred status. AHCCCS has approved 3 different biosimilar manufacturers for preferred status:
    • Simlandi products (FDA approved for interchangeability with Humira)
    • Hadlima products (FDA has accepted their application for interchangeability with Humira)
    • Unbranded Adalimumab-ABDM products manufactured by Boehringer Ingelheim (not currently FDA approved for interchangeability with Humira)

  • 07.26.2024 - Attention AHCCCS Medicaid Providers: *Coming Soon* Healthcare Network Employee Questionnaire (HNEQ)
  • 07.09.2024 - IMPORTANT: Covered Behavioral Health Services Guide (CBHSG) with an effective date of October 1, 2024

This resource will be available to Providers by COB Friday, July 12, 2024.

The CBHSG is not subject to public comment; however, AHCCCS will be collecting questions on the guide between July 15, 2024  and September 15, 2024. Questions will be used to inform a frequently asked questions (FAQ) document as well as develop training materials for providers and stakeholders. Please submit all questions via email to CBHSGCodingQuestions@azahcccs.gov.

The guide has been published to the Medical Coding Resources page and can be found under the Behavioral Health Service Matrix and Guide drop down https://www.azahcccs.gov/PlansProviders/MedicalCodingResources.html.

We encourage you to review this material and submit questions as outlined above.

  • 04.18.2024 - Required health care workforce survey opens April 16
  • 12.15.2022 - Medicaid: Appointment Availability Surveys
  • 12.08.2022 - Providers need to revalidate or re-enroll with AHCCCS or risk disenrollment. If you need to re-enroll or revalidate, please use this link to the APEP Portal https://azahcccs.gov/APEP. If you have questions about the process, you can contact apeptrainingquestions@azahcccs.gov and include the following information: APEP application ID number, name and NPI number.
  • 12.07.2022 - Arizona Revised Statute §36-109 requires that ADHS collect the following information each quarter from hospital, health care facility and outpatient substance abuse treatment providers that provide substance use treatment. Please find the survey link for Quarter 3 (July 1, 2022 to September 30, 2022) of Calendar Year 2022 below.  ADHS is requesting that your facility complete the survey no later than December 15, 2022. Here is the Survey Monkey link: https://www.surveymonkey.com/r/KYW29NW..The information you submit is important to assessing Arizona's progress in meeting the treatment needs of people throughout the state.  The information is analyzed and compiled into a quarterly report that is provided to the Governor, the Presidents of the Arizona House and Senate, and the Arizona Secretary of State's Office. The quarterly reports are also posted on the ADHS opioid website at https://azhealth.gov/opioid under the reporting tab. If you have any questions or comments, please email azopioid@azdhs.gov , and an ADHS staff will reach out to you. 
  • 11.17.2022 - Synagis Prior Authorization (PA) protocols - New Requirements /Change to Process. Effective Friday November 11th, AHCCCS notified the MCOs that the state PDL-imposed Synagis Prior Authorization (PA) protocols should now be waived by the AHCCCS contractors for eligible plan members under the age of 2 years. For UHC Community Plan (UHCCP) members, the PA process also serves as an opportunity to ensure the therapy is being ordered from the correct specialty pharmacy, Optum Specialty Rx, and can be efficiently delivered to the correct treatment sites. Although UHCCP has taken steps to remove the PA requirements per AHCCCS for eligible members less than 2 years of age, providers must continue to utilize the approved network pharmacy Optum Rx. To order, providers must call Optum Specialty at 855-427-4682 to provide the necessary information to support provider requests for UHCCP eligible membership. Synagis coverage information can be found here: Synagis® (Palivizumab) – Community Plan Medical Benefit Drug Policy Synagis® (Palivizumab) – Community Plan Medical Benefit Drug Policy (uhcprovider.com) 
  • 11.16.2022 - AHCCCS has recently updated all the Durable Medical Equipment (DME) Category of Service ( AHCCCS COS) 15 and Medical Supply (AHCCCS COS) 40 codes to match the Center for Medicare Services list on DMEPOS. All code ranges have been re-entered into the system as single codes due to the specific AHCCCS COS for the specific code. Also updated was the DME Place of Service for all DME codes to match current National Coding Standards. Current guidance states for DME, the place of service billed must be under the POS that the member will use the DME product even if it is dispensed from the provider's office. AHCCCS temporarily updated reference tables for the following: Place of Service 11 is added back to V2020-V2799 with no lapse until 9/1/2022. Providers should update their billing systems as claims after that date will not be allowed.                                AHCCCS Medical Coding Resources, News and Updates:  https://www.azahcccs.gov/PlansProviders/MedicalCodingResources.html
  • 11.10.2022 - Are you interested in providing school-based services? Arizona Health Care Cost Containment System (AHCCCS) covers school-based health care services, like medically necessary behavioral health services, for Medicaid-enrolled students. UnitedHealthcare Community Plan of Arizona connects health care providers with schools and school districts for these and other programs. If you’re interested in providing school-based services, please talk to Pilar Vargas, Children’s Healthcare Administrator, at pilar_vargas1@uhc.com or 602-255-8880.
  • 10.27.2022 - “EPSDT AMPM 430 was updated 10/1/22” – Changes included Attachment A (EPSDT Periodicity Schedule) and Attachment E (EPSDT Clinical Sample Templates) revised to include “Postpartum Depression Screening” for birthing parent and “Suicide Screening” for members ages 10-20 y.o., language added to clarify there is no limit to glasses replacements. A section was added to allow for counseling visits for immunizations exclusive to a well child visit. Language was revised to align with most recent changes in AMPM 431. Language added to cover cochlear implants for unilateral severe hearing loss. A section was added to address transition out of EPSDT for members. A section was added for developmental surveillance and language clarified for developmental screening.” AHCCCS Medical Policy Manual (AMPM) (azahcccs.gov) 
  • 10.17.2022 - DUGless Portal Guide - All health care professionals who typically provide social determinant/demographic/outcome elements with no identified alternative data source or Social Determinant diagnosis identifier can access the DUGless Portal.

Click here to access the Monthly Network News Brief articles

Access the articles shared in the monthly network news brief emails. Arizona-specific information is identified along with the date the article was shared. Review this regularly to keep up to date on the Community Plan of Arizona updates and reminders.

For Medical Policies, Medical Benefit Drug Policies, Coverage Determination Guidelines, Utilization Review Guidelines and corresponding update bulletins for UnitedHealthcare Community Plan, visit the Policies and Protocols section.

Visit the Payment Policy Notifications page to view updates. 

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