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CAA Implementation Update and Information

Date: 09/29/25

Overview: Consolidated Appropriations Act (CAA) Section 5121

Phase 1 Implementation Effective October 1, 2025

This summary outlines key points from the AHCCCS informational document regarding the CAA of 2023, Section 5121.

Purpose:

CAA Section 5121 requires Medicaid and CHIP programs to provide essential health services to eligible juveniles in carceral settings within 30 days prior to their release. The goal is to improve continuity of care, reduce recidivism, and support successful community reintegration.

Who Is an Eligible Juvenile?

  • Medicaid/CHIP-eligible individuals under age 21
  • Individual ages 18–26 eligible under the former foster care children group.

Phase I Details

  • Go-Live Date: October 1, 2025
  • Facility: Adobe Mountain School (Arizona Department of Juvenile Corrections (ADJC))

Note: ADJC IS THE ONLY FACILITY INCLUDED IN PHASE 1.

  • Future Expansion: Adult prisons, detention centers, county jails, and tribal entities through 2028

Impacted Providers

A list of AHCCCS-identified providers is attached to this notice.

Provider Responsibilities

1.    Referral Process

  • ADJC sends referrals 60 days prior to release
  • Referrals go to Managed Care Organization (MCO) Justice Liaisons or AHCCCS (for AIHP enrollees)
  • MCO Justice Liaisons initiate referrals to contracted providers (in line with the current process)

2.    Pre-Release Services (within 30 days)

Providers must:

  • Initiate outreach to the facility
  • Begin Targeted Case Management (TCM)
  • Review EPSDT screenings from ADJC and conduct additional assessments
  • Develop post-release service plan including:
    • Coordination with guardians/HCMD/DR and probation
    • Initiate referrals for specialty services
    • Schedule follow-up appointments
    • Prepare prescriptions for member’s release from incarceration
    • Connection to community-based services

3.    Billing Guidance

  • Pre-release services are fee-for-service, billed directly to AHCCCS
  •  Use T1017 for services while the juvenile is incarcerated
  • Only identified community providers may bill during the pre-release period
  • After release, bill T1016 to the member’s plan of enrollment

4.    Billing Codes

Refer to the attached AHCCCS informational document for approved codes

Some codes become active October 1, 2025; others in early 2026

Contact Information

AHCCCS Contacts

Arizona Complete Health – Complete Care Plan Contacts

For a list of impacted providers or the AHCCCS FAQ please reach out to AzCHProviderCommunications@azcompletehealth.com.