Monday, March 16, 2009

If you benefit from CRS (Child Rehabilitative Services)

you may have received, or may soon receive the following letter:

March 9, 2009
State Budget Cut Impacts CRS Program.
State-only 0% Members Move to State-only 100%.
Dear APIPA-CRS Member:
The state of Arizona is faced with very difficult budget challenges. To help balance Arizona's Fiscal year 2009 budget, the Arizona Department of Health Services carefully examined how to eliminate more than $30 million from its budget. Because of these budget cuts, it was necessary to end state funding for medical services for Children's Rehabilitative Services (CRS) members who are not enrolled in the Arizona Health Care Cost Containment System (AHCCCS).
AHCCCS members who are enrolled in CRS do not pay for CRS services. Children who are CRS eligible, but who are not on AHCCCS, may participate in CRS as "State Only" members. These members were divided into two groups, according to their family income levels. One group could access the CRS network of providers, but paid for CRS services themselves, or through other insurance coverage. These members were referred to as 100% pay members. The other group was eligible for services at no cost, and was referred to as 0% pay members.
Beginning March 20, 2009 the following changes will occur:
• Existing CRS members that do not have coverage under AHCCCS will become 100% pay members, which means they will have to pay for all costs for CRS services after any other insurance coverage.
• AHCCCS members are not affected by this change, unless their enrollment in AHCCCS ends. At any point that a CRS member is not covered by AHCCCS, they will be considered to be 100% pay members, and will have to pay for all costs for CRS services while not enrolled in AHCCCS.
• A Continuity of Care Plan will continue from March 20, 2009 through June 30, 2009. During this time, for members who have been moved from the State Only 0% payment group into the State only 100% payment group, APIPA-CRS will pay for CRS services that are approved before March 20,2009 and provided before June 30, 2009. APIPA-CRS will also pay for maintenance drugs related to CRS conditions through June 30, 2009.
You can get an application for AHCCCS and see the eligibility requirements for AHCCCS at or call to 602-417-4000. For those who are not on AHCCCS, a Payment Agreement Form indicating that you accept 100% payment responsibility isenclosed for your signature. You cannot receive CRS services, except for services that are approved before March 20, 2009 and provided before June 30, 2009 until this form is signed and returned to
Attn: APIPA-CRS Enrollment,
PO Box 33320,
Phoenix, AZ 85067-3320.
Appeals of this decision are limited to disagreements about temporary coverage described under the continuity of care plan. An appeal must be filed within 60 days from a denied request, and may be filed over the phone, in person or in writing. To appeal over the phone, you can call us at 1-866-275-5776.
If you want to appeal in writing mail to Attn: APIPA-CRS Appeals, 3141 N 3rd Ave, Phoenix, AZ 85013.
Our Member Services Department is available to assist you or answer your questions at 1-866-275-5776.
APIPA-CRS Member Services
CRS Payment Agreement Form

Advocacy and contact info will be in the next entry.

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