PHOENIX — A Scottsdale outpatient drug and alcohol treatment center says it will close its doors this week due to cuts to Arizona Medicaid.
The Arizona Health Care Cost Containment System, known as AHCCCS, announced as of May 1, certain providers now get a flat rate of $157 dollars per patient per day for intensive outpatient drug treatment services.
AHCCCS said it made the decision after thorough data analysis and to bring its reimbursement rate more in line with the industry average. The changes will affect only about 10 percent of their behavioral health providers.
Sunrise Native Recovery in Scottsdale says that includes 70 patients, all of whom are Native American.
Phoenix resident Curtis Nez credits outpatient treatment with helping him stay sober.
Before treatment, the 36-year-old didn’t have a home or a job. He wasn’t even sure what day it was. Today, he is studying to be an electrician technician.
“I’m living proof. I’m 16 months sober,” he said.
Nez received outpatient services through Sunrise Native Recovery, an outpatient drug-and-alcohol treatment center. Those services are now in jeopardy.
Arizona Health Care Cost Containment System, known as AHCCCS, on May 1 changed the way it reimburses providers for outpatient treatment services through the Fee-For-Service program. Instead of reimbursing providers a percentage of their charges, they will get a flat rate per patient per day.
Officials at Sunrise Native Recovery in Scottsdale said the change will result in up to a 90 percent cut in funding.
“A lot of people are gonna fall through the cracks,” said Allen King, Sunrise’s chief administrative officer. “Because there's gonna be literally no services.”
For example, at Sunrise Native Recovery their reimbursement has been $1,300 per patient per day. That will drop to $157 per patient per day.
The money funds group therapy and cultural activities at the center as well as transportation to and from the center, meals and housing.
Already, in the days leading up to May 1, the culturally based addiction treatment center with two locations moved its 70 patients to a single location in preparation for the potential funding changes.
Sunrise will see a drastic funding cut because all of its patients are Native American. Native Americans are enrolled in a special subset of AHCCCS called Fee-For-Service. And it’s only the Fee-For-Service Program that’s facing these cuts.
The change affects outpatient alcohol and drug treatment programs. These are intensive services, provided at least three hours a day and at least three days a week.
Darrin Miller, chief executive officer at the River Source, a drug-and-alcohol treatment center with several locations that offers inpatient and outpatient services. He predicts the change will have “an absolutely massive impact” on the ability of some people to get outpatient treatment.
“It’s absolutely horrific,” he said of the change.
AHCCCS declined an interview request with ABC15. In a statement, the agency acknowledged that “some providers may see a reduction in reimbursement based on how they currently bill.” The agency estimates the change would save $1.1 million over five months. The agency confirmed to ABC15 that most of the affected patients are Native American.
AHCCCS said the change may impact about 223 providers or about 10 percent of more than 2,200 providers.
Residential rehab centers, which aren’t subject to the cuts, worry about what will happen once they discharge their patients.
“We will have nowhere to send these patients. And ultimately what will happen is without that support, they will most likely use or drink again,” said Gabriel Tomaeno, co-founder of Purpose Healing Center, a residential treatment center with locations in Phoenix and Scottsdale.
Without outpatient services, people will relapse, said Robin Byrne, Purpose Healing co-founder.
“People are going to die,” she said.
AHCCCS wouldn’t comment on a question from ABC15 on whether the change is an effort to reduce fraud in the state Medicaid system.
King said the change appears to be an attempt to crack down on AHCCS funding abuse. But he said the solution is not to change the funding for all providers. That will just result in fewer services overall.
“A lot of people who are seeking recovery, this is going to hurt them a lot,” he said. “It’s heartbreaking.”
Email ABC15 Investigator Anne Ryman at anne.ryman@abc15.com, call her at 602-685-6345, or connect on Twitter and Facebook.
