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DDHA (Dr. Ted Kastner's group) has notified AmeriChoice that effective July 1st, it no longer will serve as the primary care physician for persons with developmental disabilities. DDHA will continue to provide Care Management services until its contract with AmeriChoice expires on September 15th. DDHA also has announced that it will close its primary care, mental health and care management practices on September 15th.

DDHA serves as the primary care physician for approximately 1500 individuals with developmental disabilities. AmeriChoice is beginning today to take steps to notify these individuals about the situation and provide them with contact information for a newly assigned primary care physician.

AmeriChoice will provide this notification in three different ways:

  • First, AmeriChoice will send each individual a "Special Service Letter" that identifies a new PCP.
  • Second, an AmeriChoice representative will visit each group home to speak with individuals and group home staff about the situation, and
  • Third, AmeriChoice staff will call each individual to inform them of the change.

The "Special Service Letter" will include a phone number that individuals can call if they would like to select a different primary care physician. Individuals should take the letter with them to any physician appointment until they receive their new AmeriChoice card in the mail.

In preparation for sending the "Special Service Letter" to these individuals, AmeriChoice identified and called all the physicians in its network who already are serving individuals with developmental disabilities. More than sixty of these physicians indicated that they could serve additional individuals.

AmeriChoice is in the process of completing outreach to all behavioral health providers in its network to identify those who would be willing to accept additional individuals into their practice. These phone calls are continuing today.

A concern has been raised about continuity of medication for individuals who do not have refills authorized for their prescriptions. It is critical that any individual with a prescription that will run out in the next month should schedule a physician visit as soon as possible. We also recommend that all individuals ask DDHA to release their medical records to their new primary care physician.

AmeriChoice will honor any out-of-network services during the transition period.

The Division of Developmental Disabilities plans to make space available at each of its developmental centers for physicians who wish to provide services in remote locations. In addition, when we receive a copy of the finalized "Special Service Letter," we will provide it to the provider organizations so that your staff can review it. We also plan to post information about this situation on our website within the next few days.

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