ALTCS Recipients – Brace for Budget Cuts!

By February 16, 2009Uncategorized

Unfortunately, due to the state budget deficit, the AHCCCS Part D Co-Payment Program, administered by RxAmerica to cover Medicare Part D co-payments for AHCCCS Dual Eligible Members, will be discontinued as of March 1, 2009.


Under Arizona Laws 2008, Chapter 285, Section 3, and Arizona Revised Statutes, Section 35-154, funding cannot be provided for a program other than what is allowed in the state budget.


All AHCCCS Dual Eligible Members ( this means those on Medicare and ALTCS)  have been sent a letter to inform them of the discontinuation of this program and that the pharmacy may require payment of Medicare Part D co-payments prior to a member receiving prescriptions that are covered under the Medicare Part D benefit.


The discontinuation of the AHCCCS Part D Co-Payment Program applies to all dual eligible members, therefore members are not entitled to a hearing on this decision.  Please see Arizona Administrative Codes R9-34-319 and R9-3422.


Please remember that any member residing in a nursing home- for a period longer than 30 days – is exempt from this ruling.   Those members will have their prescription co-pays covered.  If the member lives in their own home or in an assisted living center the co-pay will not be covered.   If this will be a hardship for you, please contact your case manager with the program contractor you use.  If you, or the member, is in an assisted living facility, it may be a good idea to discuss with the Case Manager a room and board reduction agreement to help you handle these new costs.