AHCCCS; contractors; opioid treatment programs; reimbursement; report; definitions

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36-2907.14. AHCCCS; contractors; opioid treatment programs; reimbursement; report; definitions

A. Pursuant to section 36-2907, the administration and its contractors may reimburse an opioid treatment program provider for enrolled members only if the provider demonstrates enforcement of each plan contained in the annual report pursuant to subsection B of this section and the administration approves the report pursuant to subsection C of this section.

B. An opioid treatment program provider that receives reimbursement from the administration or its contractors shall submit an annual report on a schedule that is prescribed by the administration and that contains all of the following:

1. A detailed security plan that incorporates standards from the substance abuse and mental health services administration and the United States drug enforcement administration. The plan shall include patient management strategies that are designed to reduce potential harm to patients and lower the risk of exposure to illicit transactions and other consequences of overcrowding and poor patient management.

2. A neighborhood engagement plan that outlines engagement with key stakeholders in the neighborhood in which the opioid treatment program is located, including homeowners' associations, school administrators, neighboring businesses, community organizations, the city or town council and local law enforcement. The plan shall include information about ensuring consideration of and response to reasonable safety, security and trash removal concerns, concerns regarding adequate parking for patients and staff and other matters of concern to the entities prescribed in this paragraph.

3. A comprehensive plan related to the care of all patients to demonstrate how the opioid treatment program ensures that appropriate standards of care are met for medication-assisted treatment, including dosing, the provision of or referral to appropriate counseling and behavioral therapy services and peer support services, as required by the substance abuse and mental health services administration. This plan shall include whether the opioid treatment program provides the therapy services directly or refers patients for services through a separate provider. If the program refers patients for services through a separate provider, the report shall include strategies employed to ensure patients are able to access referred services in a timely manner.

4. A community relations and education plan that includes policies and procedures to measure and minimize the negative impact the opioid treatment program may have on the community, to promote peaceful coexistence and to plan for change in the program and program growth, including:

(a) Considering community needs and impacts when selecting a site for the program or program growth.

(b) Considering community input on the potential impact the program may have on the community.

(c) Maintaining a clean and orderly facility that does not impede pedestrian or traffic flow.

(d) Communicating with community leaders to foster good community relations.

(e) Developing and implementing a community relations plan that is specified to the needs of the program within its community and that includes the following actions:

(i) Establishing a liaison with community representatives to share information about the program, the community and mutual concerns and issues.

(ii) Identifying program personnel who will function as community relations coordinators and define the goals and procedures of the community relations plan.

(iii) Serving as a community resource on substance use and related health and social issues as well as promoting the benefit of medication-assisted treatment in preserving the public health.

(iv) Soliciting community input about medication-assisted treatment and the program's presence in the community.

(v) Developing program policies and procedures to effectively address or resolve community problems, including patient loitering and medication diversion, and ensuring that program operations do not affect community life adversely.

(vi) Documenting community contacts and community relations efforts and evaluating the effectiveness of activities over time in addressing outstanding problems or deficiencies.

(vii) Disclosing the process for community contacts to notify the administration's clinical resolution unit of any unresolved problems or deficiencies that includes, if appropriate, coordination with the state opioid treatment authority.

(viii) Developing communication mechanisms that provide interested parties and potential patients with general information about the program outside of regular operating hours.

5. A current diversion control plan that contains specific measures to reduce the possibility of diversion of controlled substances from legitimate treatment use.

C. The administration shall post the reports received pursuant to subsection B of this section on its public website. The administration shall notify each city or town in which an opioid treatment program is located of the posted report and allow the city or town thirty days to provide comments on the report. The administration shall consider the city's or town's comments on the report and approve or reject the annual report within thirty days after the close of the comment period. If the administration identifies areas of concern regarding compliance with state rules, federal regulations or administration policies, the administration must provide the opioid treatment program thirty days to revise the report. The administration shall also take any appropriate regulatory action based on the deficiencies identified. If the opioid treatment program does not submit the report within the required timelines or does not demonstrate enforcement of each plan contained in the report, or if the administration does not approve the report initially or after the requested revision, the administration, with appropriate notification to the provider, shall suspend reimbursement by the administration or its contractors to the opioid treatment program until the report is approved.

D. On or before January 15 of each year, the administration shall submit a report to the governor, the president of the senate and the speaker of the house of representatives that summarizes the reports submitted pursuant to subsection B of this section. A copy of the report shall be provided to the secretary of state.

E. For the purposes of this section:

1. " Medication-assisted treatment" has the same meaning prescribed in section 32-3201.01.

2. " Opioid treatment program" means a licensed and accredited program that is authorized to dispense medications for the treatment of opioid use disorders through highly structured protocols defined in federal regulations and state rules.


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