Common use of System Changes Clause in Contracts

System Changes. Changes to the Department of Economic Security AZTECS eligibility system: AZTECS will not approve Childless Adults for applications dated July 8, 2011 or later. It will approve Childless Adults for applications dated prior to July 8, 2011, if all eligibility criteria were met prior to July 8, 2011. AZTECS will generate Notice #7. It will allow children aging out of the 1931, SOBRA Child, and YATI programs to move into Childless Adults if they meet the eligibility requirements. • Changes to the AHCCCS ACE eligibility system: ACE will not approve Childless Adults for applications dated July 8, 2011 or later. It will approve Childless Adults for applications dated prior to July 8, 2011, if all eligibility criteria were met prior to July 8, 2011. ACE will generate Notice #7. It will allow children aging out of the 1931, SOBRA Child, and KidsCare programs to move into Childless Adults if they meet the eligibility requirements. • Changes to the AHCCCS PMMIS system: On July 8, 2011 PMMIS will stop accepting Childless Adults for eligibility effective July 8, 2011 or later. It will accept Childless Adults eligibility from children aging out of the 1931, SOBRA Child, YATI, and KidsCare programs. It will permit manual update of Childless Adults for cases closed in error. It will produce notices #1, #2, #3, #4, #5, #6, #8, #9 and #10. PMMIS will move members age 65 and older, and members under age 65 with Medicare to SSI MAO. PMMIS will post a file of those members in the DES AZTECS system and the AHCCCS ACE system to close their Childless Adult cases. PMMIS will produce a file of these members so they can be added into the ACE system as SSI MAO eligibles. AHCCCS will run this process every month effective June 28, 2011. AHCCCS will identify individuals from the PMMIS Claims and Encounters systems, who have a diagnosis code of 042 (HIV/AIDS) and/or who have a pharmacy claim or encounter for an antiretroviral. We will create an electronic file of these individuals monthly and run it against our PMMIS Recipient system monthly to ensure their Childless Adult cases remains active. If a future termination date is sent for these members, PMMIS can identify through the coding if the case is being closed because they did not comply with the redetermination process. If it is, the member will be transferred to SSI MAO and scheduled for a redetermination, without a break in their coverage. AHCCCS will run this process every month, effective June 28, 2011. AHCCCS will identify individuals from the PMMIS Recipient System, who have been identified as SMI. We will transfer all of these individuals to SSI MAO on July 1, 2011 and schedule them for a redetermination, without a break in their coverage. AHCCCS will run this process every month. The 270/271 process for eligibility and enrollment verification will be updated to include redetermination dates for each member effective June 19, 2011. This process includes web based and IVR tools. Batch 270/271 will be updated effective October 1, 2011. • Changes to the AHCCCS/DES Health-e-Arizona on line application and renewal system: Effective July 8, 2011 Health-e-Arizona will stop screening for Childless Adults.

System Changes.  Changes to the Department of Economic Security AZTECS eligibility system: AZTECS will not approve Childless Adults for applications dated July 8, 2011 or later. It will approve Childless Adults for applications dated prior to July 8, 2011, if all eligibility criteria were met prior to July 8, 2011. AZTECS will generate Notice #7. It will allow children aging out of the 1931, SOBRA Child, and YATI programs to move into Childless Adults if they meet the eligibility requirements. •  Changes to the AHCCCS ACE eligibility system: ACE will not approve Childless Adults for applications dated July 8, 2011 or later. It will approve Childless Adults for applications dated prior to July 8, 2011, if all eligibility criteria were met prior to July 8, 2011. ACE will generate Notice #7. It will allow children aging out of the 1931, SOBRA Child, and KidsCare programs to move into Childless Adults if they meet the eligibility requirements. •  Changes to the AHCCCS PMMIS system: On July 8, 2011 PMMIS will stop accepting Childless Adults for eligibility effective July 8, 2011 or later. It will accept Childless Adults eligibility from children aging out of the 1931, SOBRA Child, YATI, and KidsCare programs. It will permit manual update of Childless Adults for cases closed in error. It will produce notices #1, #2, #3, #4, #5, #6, #8, #9 and #10. PMMIS will move members age 65 and older, and members under age 65 with Medicare to SSI MAO. PMMIS will post a file of those members in the DES AZTECS system and the AHCCCS ACE system to close their Childless Adult cases. PMMIS will produce a file of these members so they can be added into the ACE system as SSI MAO eligibles. AHCCCS will run this process every month effective June 28, 2011. AHCCCS will identify individuals from the PMMIS Claims and Encounters systems, who have a diagnosis code of 042 (HIV/AIDS) and/or who have a pharmacy claim or encounter for an antiretroviral. We will create an electronic file of these individuals monthly and run it against our PMMIS Recipient system monthly to ensure their Childless Adult cases remains active. If a future termination date is sent for these members, PMMIS can identify through the coding if the case is being closed because they did not comply with the redetermination process. If it is, the member will be transferred to SSI MAO and scheduled for a redetermination, without a break in their coverage. AHCCCS will run this process every month, effective June 28, 2011. AHCCCS will identify individuals from the PMMIS Recipient System, who have been identified as SMI. We will transfer all of these individuals to SSI MAO on July 1, 2011 and schedule them for a redetermination, without a break in their coverage. AHCCCS will run this process every month. The 270/271 process for eligibility and enrollment verification will be updated to include redetermination dates for each member effective June 19, 2011. This process includes web based and IVR tools. Batch 270/271 will be updated effective October 1, 2011. •  Changes to the AHCCCS/DES Health-e-Arizona on line application and renewal system: Effective July 8, 2011 Health-e-Arizona will stop screening for Childless Adults.

System Changes. Changes to the Department of Economic Security AZTECS eligibility system: AZTECS will not approve Childless Adults for applications dated July 8, 2011 or later. It will approve Childless Adults for applications dated prior to July 8, 2011, if all eligibility criteria were met prior to July 8, 2011. AZTECS will generate Notice #7. It will allow children aging out of the 1931, SOBRA Child, and YATI programs to move into Childless Adults if they meet the eligibility requirements. • Changes to the AHCCCS ACE eligibility system: ACE will not approve Childless Adults for applications dated July 8, 2011 or later. It will approve Childless Adults for applications dated prior to July 8, 2011, if all eligibility criteria were met prior to July 8, 2011. ACE will generate Notice #7. It will allow children aging out of the 1931, SOBRA Child, and KidsCare programs to move into Childless Adults if they meet the eligibility requirements. • Changes to the AHCCCS PMMIS system: On July 8, 2011 PMMIS will stop accepting Childless Adults for eligibility effective July 8, 2011 or later. It will accept Childless Adults eligibility from children aging out of the 1931, SOBRA Child, YATI, and KidsCare programs. It will permit manual update of Childless Adults for cases closed in error. It will produce notices #1, #2, #3, #4, #5, #6, #8, #9 and #10. PMMIS will move members age 65 and older, and members under age 65 with Medicare to SSI MAO. PMMIS will post a file of those members in the DES AZTECS system and the AHCCCS ACE system to close their Childless Adult cases. PMMIS will produce a file of these members so they can be added into the ACE system as SSI MAO eligibles. AHCCCS will run this process every month effective June 28, 2011. AHCCCS will identify individuals from the PMMIS Claims and Encounters systems, who have a diagnosis code of 042 (HIV/AIDS) and/or who have a pharmacy claim or encounter for an antiretroviral. We will create an electronic file of these individuals monthly and run it against our PMMIS Recipient system monthly to ensure their Childless Adult cases remains active. If a future termination date is sent for these members, PMMIS can identify through the coding if the case is being closed because they did not comply with the redetermination process. If it is, the member will be transferred to SSI MAO and scheduled for a redetermination, without a break in their coverage. AHCCCS will run this process every month, effective June 28, 2011. AHCCCS will identify individuals from the PMMIS Recipient System, who have been identified as SMI. We will transfer all of these individuals to SSI MAO on July 1, 2011 and schedule them for a redetermination, without a break in their coverage. AHCCCS will run this process every month. The 270/271 process for eligibility and enrollment verification will be updated to include redetermination dates for each member effective June 19, 2011. This process includes web based and IVR tools. Batch 270/271 will be updated effective October 1, 2011. • Changes to the AHCCCS/DES Health-e-Arizona on line application and renewal system: Effective July 8, 2011 Health-e-Arizona will stop screening for Childless Adults.