Administrative Law Judge Sends AHCCCS Back to the Drawing Board on their ALTCS EPD Contract Awards

Last week an Administrative Law Judge ruled that AHCCCS made ‘significant errors’ in awarding recent contracts for healthcare services for persons enrolled in the Arizona Long Term Care System for “the elderly & physically disabled” (EPD).

The ruling was not about and has no impact on the ALTCS system for folks with developmental disabilities that are not members of EPD.

Judge finds ‘serious flaws’ in AZ Medicaid program’s contract awards

The judge identified multiple issues, including a lack of transparency and inconsistencies in the evaluation process that have the potential to “lead to unfair advantages for certain contractors, potentially undermining the quality of care provided to members of the ALTCS EPD program.

“Due to the serious flaws in the procurement process and the arbitrary outcome of the award determination, it is recommended that appellants’ appeal be granted, the procurement canceled and a new request for proposals issued.” – Administrative Law Judge Sondra J. Vanella

The ALTCS program provides services like nursing care, case management, and home and community-based services, aiming to keep elderly and physically disabled individuals in the least restrictive environment possible.

The case could lead to revisions in the way AHCCCS conducts its procurement processes to better ensure this and future contracts are awarded more fairly and transparently…  essential ingredients for hiring the right contractors who provide essential healthcare services in Arizona’s Medicaid program.

Note: This ruling is from an ‘Order’ from Administrative Law Judge, not a Superior Court judge. While the ALJ issued this ‘Order’ the AHCCCS director can elect not to heed that order. Directors cannot just dismiss Superior Court rulings.