36-2948. Prohibited collection practices On oral or written notice from the member or person that the member or person believes the claims to be covered by the system, a provider or noncontracting provider shall not do either of the following unless the provider or noncontracting provider has verified through the administration that the member or […]
36-2949. Exemption from insurance law To the extent that services are provided pursuant to this article, a provider or program contractor is not subject to the provisions of title 20.
36-2950. Services to persons with disabilities; eligibility; premiums A. Subject to the approval of the centers for medicare and medicaid services, beginning on January 1, 2002, the Arizona health care cost containment system administration shall provide services pursuant to this article to any person with a disability who is defined as eligible pursuant to section […]
36-2951. Self-directed attendant care services; rules; definition A. Notwithstanding any law to the contrary, a person enrolled in the Arizona long-term care system may employ another person to provide self-directed attendant care services that would otherwise be considered within the scope of nursing care pursuant to title 32, chapter 15 if: 1. The person receiving […]
36-2952. County or special health care district long-term care system fund; uniform accounting A. Each county or special health care district that is a program contractor pursuant to section 36-2940 shall establish and maintain a county or special health care district long-term care system fund as a separate fund to distinguish its revenues and its […]
36-2953. Department long-term care system fund; uniform accounting; reporting requirements A. The department shall establish and maintain a department long-term care system fund, which is a separate fund to distinguish its revenues and its expenditures pursuant to this article from other programs funded or administered by the department. Subject to legislative appropriation, the fund shall […]
36-2954. Erroneous eligibility determination; state liability If the director determines through the grievance and appeal procedure pursuant to a grievance or appeal filed by an applicant that the administration made an error in eligibility determination pursuant to section 36-2933 and a person was incorrectly determined to be ineligible to receive institutional or home and community […]
36-2955. Inappropriate services; federal sanctions A. Notwithstanding section 36-2940, the director shall adopt rules which provide that the administration shall withhold or forfeit capitation payments to the program contractor pursuant to section 36-2940 if the program contractor provides inappropriate services to a person determined eligible pursuant to section 36-2933 in an amount which equals the […]
36-2956. Liens on damages for injuries; notification A. The administration is entitled to a lien for the charges for hospital, medical or long-term care and treatment of an injured person for which the administration or a program contractor is responsible pursuant to this article, on any and all claims for damages accruing to the person […]
36-2957. Prohibited acts; penalties A. No person may present or cause to be presented to the administration or to a program contractor: 1. A claim for an item or service that the person knows or has reason to know was not provided as claimed. 2. A claim for an item or service that the person […]
36-2958. Absence of federal financial participation; effect on system operation If at any time federal monies as described in section 36-2932, subsection I, paragraph 2 are denied, not renewed or become unavailable for any reason the provisions of this article relating to the operation of the system are suspended and the director shall notify each […]
36-2959. Reimbursement rates; capitation rates; annual review A. The department shall contract with an independent consulting firm for an annual study of the adequacy and appropriateness of title XIX reimbursement rates to service providers for the persons with developmental disabilities program of both the Arizona long-term care system and the state only program. The consultant […]
36-2960. Persons with developmental disabilities; cost-effectiveness study rate; report The department shall annually determine the cost-effectiveness study rate for persons who are receiving developmental disability services pursuant to chapter 5.1 of this title and provide that rate to the Arizona health care cost containment system administration. On or before June 15 of each year, the […]
