Augmentative and Alternative Communications (AAC) systems are used to establish functional communication when natural speech methods are insufficient to achieve daily communication goals and meet communication needs.
AAC is augmentative when used to supplement existing speech and alternative when used in place of speech that is absent or not functional.
The provision of AAC is divided into two broad categories: unaided and aided.
Unaided forms of AAC do not require an external tool. Unaided forms require some degree of motor control.
Aided forms of AAC require some form of external support and can be categorized into non-technology—non-DME and technology-based products DME.
Non-technology products are non-electronic boards or books that contain images that the individual selects to convey messages. E.g., picture symbols, alphabet boards, photograph books).
Technology-based systems employ hardware and software to produce visual output, that is, digitally displayed messages. I.e., dynamic or static displays or voice output (Speech-Generating Devices [SGDs] and mobile AAC technologies).
SGDs are defined as durable medical equipment that provides an individual who has a severe speech impairment with the ability to meet his or her functional speaking needs. SGDs are speech aids consisting of devices or software that generate speech and are used solely by the individual with a severe speech impairment. DDD covers SGDs for all eligible members of all ages if the SGD is considered medically necessary.
AAC Benefit Administration
The Division posted for public comment on proposed changes to the administration of the AAC benefit from June 29, 2020, - July 13, 2020. Click the link below to read that information as well as frequently asked questions related to the public comment solicitation.
What does this change mean for DDD members? AAC services are still a covered benefit. This change means better access to medically necessary AAC services. It will also support a timely and efficient prior authorization process for AAC and related services.
Will a member’s Support Coordinator still be engaged in the process? Yes, the member’s Support Coordinator will still be part of this process. The Support Coordinator will help the member complete the referral packet. They will also help the member submit the packet to the DDD Health Plan. The Support Coordinator will monitor the authorization request until a decision is made. The Support Coordinator will monitor the process until the member receives the device and authorized training for approved requests.
Will the same providers continue to be available? Many of the current DDD providers are already contracted with the DDD Health Plans. DDD and the DDD Health Plans will work with members to identify the best provider to meet each member’s needs.
How will DDD monitor the Health Plans for the administration of this service? DDD’s contract with AHCCCS (Arizona Health Care Cost Containment System) requires DDD to monitor the delivery of services by the DDD Health Plans. DDD will oversee and monitor: • The prior authorization process. • Determination decisions. • The timeliness of the process. • Delivery of approved devices and training.
Will the administration of the ACC benefit by the DDD Health Plans cover all of Arizona? Yes, the DDD Health Plans cover all of Arizona.
Will this affect the timeliness of authorization decisions? The DDD Health Plans use a prior authorization process for requested services. They also have the staff and resources to meet their service delivery requirements. DDD expects the DDD Health Plans will meet timeliness of authorizations requirements.
Were families and providers able to provide comments regarding this proposed change? Yes, DDD posted the proposed administration benefit change for public comment on June 29, 2020, and accepted comments through July 13, 2020. This information was sent to all subscribers to Division policy updates. It was also placed on the Division’s Facebook page directing users to the Policy webpage. There they could review the proposed change and provide comments.
How can families ask questions? Families with questions can call the DDD Customer Service Center at 1-844-770-9500 ext. 1 or via email at [email protected]. The DDD Health Plans will be holding forums before the transition. Those forums will be a great place for families to ask questions.
How can providers ask questions? Providers with questions can call the DDD Customer Service Center at 1-844-770-9500 ext. 1 or via email at [email protected]. More information for providers including training for impacted providers will be held in the weeks and months ahead. Those dates will be communicated once they are finalized. The DDD Health Plans will be holding forums leading up to the transition. Those forums will be a great opportunity for providers to ask questions
How will DDD share Personal Health Information with the DDD Health Plans? How will the DD Health Plan obtain the medical history of AAC use? DDD and DDD Health Plans will continue to ensure the confidentiality of member personal health information. DDD will provide necessary AAC data to the member’s DDD Health Plan. Data may include current services, devices and repairs. Information will be sent to the DDD Health Plans electronically. The DDD Health Plan will continue to work closely with the DDD Support Coordinator if historical information is needed for new AAC requests.
Who in DDD Healthcare Services will be providing the AAC oversight? A clinical team including subject matter experts with proper qualifications will provide oversight.
Currently, a family can choose which of the three contracted agencies will do their AAC evaluation and request a specific team to do it. How will this work with the DDD Health Plans? DDD members will still have a choice of providers within their DDD Health Plan’s network. The current AAC agencies will serve you through December 31, 2020. Starting January 1, 2021, the family will choose an agency that is contracted with their DDD Health Plan.
How can families contact their DDD Health Plan? A family can contact their DDD Health Plan by contacting their DDD Health Plan’s Member Services department.
Mercy Care - 1 (800) 624-3879
UnitedHealthcare Community Plan - 1 (800) 348-4058
What will this look like for AIHP members? DDD will manage and administer the AAC benefit for any American Indian/Alaska Natives who have selected the DDD American Indian Health Plan (AIHP) using its fee-for-service provider.
What will be the process when a member disagrees with a decision or recommendation by the health plan? Members can file a grievance or appeal a decision with their DDD Health Plan. This process can be found on each DDD Health Plan’s website. It can also be found in their member handbook.
Will a member be required to use the same DDD Health Plan for AAC services as they already use for other services? Yes, the member’s existing DDD Health Plan will provide AAC services as well as all other medically necessary, covered services.
How many training hours or visits will be provided once a member receives an AAC device? The amount of training hours or visits is based on the type of AAC system and the member’s needs. The DDD Health Plan will work with the provider to determine the training needs for each member.
What resources are available for members who want to learn more about the AAC benefit? DDD and the DDD Health Plans are creating guides for members and providers. These guides will explain the duties of the various roles in the AAC process. The guides will also explain: • What determines whether a member is eligible and for what type? • The process for receiving training. • What to do if a repair is needed. • These guides will be available before the transition to the DDD Health Plans occurs.
How will the DDD Health Plans provide improved access to benefits and timeliness? The DDD Health Plans have shown efficiency with prior authorization processes for all physical and behavioral health services that require an authorization. The DDD Health Plans currently manage all other Durable Medical Equipment benefits with the exception of AAC. The goal is to use this experience as well as their bigger provider networks. DDD will oversee the DDD Health Plans to ensure members receive quality services in a timely manner.
Currently, a family’s evaluation team is also generally the family’s training team. How would this work with the DDD Health Plans? The members of the AAC team vary depending on: • The member’s abilities. • The member’s expectations. • The member’s communication needs. • The availability of services. The team should at least include: • The member. • Key communication partners (e.g., caregivers, partner, adult children). • A licensed speech-language pathologist, in accordance with A.R.S. § 36- 1940.01, as amended. • The member’s physician. The speech-language pathologist is the lead in the AAC team evaluation process. They will provide the evaluation and training with the AAC system. The function of the evaluation team will not change after the transition to the DDD Health Plans.
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