Arkansas Department of Human Services and PASSEs Respond to Feedback, Adjust Open Enrollment and Transition Period

Open enrollment now scheduled for October 2019

(LITTLE ROCK, Ark.) – The Department of Human Services (DHS) is rescheduling open enrollment for the Provider-led Arkansas Shared Savings Entity (PASSE) program from May to October to give PASSEs more time to stabilize and grow their networks of providers. This also will give families more information before they need to decide which entities will best meet their needs. The open enrollment period for November has been canceled.

This change, along with decisions by DHS and the three PASSEs to extend the transition period for client care plans and provider network rates, has been made in response to feedback from providers, families, and legislators.

Open enrollment for the PASSE program will now run from Oct. 1-31, 2019, with an effective date of Dec. 1st. Between now and the open enrollment period, clients can ask to change PASSEs “for cause” by calling the PASSE Beneficiary Support line at 1-833-402-0672. Each for cause request will be reviewed by the office of the PASSE ombudsman. For cause reasons could include a desire to move all siblings or household members into the same PASSE or lack of access to providers experienced in dealing with clients’ care needs.

All three PASSEs will extend the transition period for clients through Sept. 1, 2019. This means PASSEs will continue to pay for clients’ current plans of care as they are now, including current authorizations for services, through that date. During the coming months, PASSE care coordinators will meet with clients to create a person-centered service plans (PCSP). PASSEs must meet with clients before any changes can be made to a client’s PCSP.

“We want PASSE clients and providers to know that we have heard their concerns, and we think these changes will help as we work through the launch of this new program. Allowing the PASSE networks to expand before open enrollment will help clients make the best choice for themselves and their families,” said Paula Stone, DHS Deputy Director of the Division of Medical Services.

On March 1, 2019, the three PASSEs – Arkansas Total Care, Empower Healthcare Solutions, and Summit Community Care – began receiving monthly payments from DHS to manage the complete healthcare of their clients. In this new organized care model, Arkansas Medicaid providers such as primary care physicians, pharmacists, hospitals, and specialty providers can join PASSE networks, and the providers are reimbursed by the PASSEs for services provided to PASSE clients.

The PASSEs also will pay all Arkansas Medicaid providers at an “in-network rate” through September 1, 2019, even if a provider is not in a PASSE’s network. With the additional time for this transition period, DHS encourages providers to join PASSE networks to ensure consistent care for clients.

The PASSE is a model of organized care created by Act 775 of 2017 to manage the services of individuals with significant developmental disabilities and behavioral health needs. To form each PASSE, local Arkansas providers entered into partnerships and chose an experienced organization to perform administrative functions, such as claims processing. These three groups function similar to insurance companies to serve nearly 45,000 Medicaid-eligible individuals.

PASSEs are a Medicaid provider type approved by the Centers for Medicare & Medicaid Services (CMS). They are regulated by the Arkansas Insurance Department (AID) and held accountable to the Department of Human Services (DHS) under federal managed care rules.

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