Ariz. Admin. Code § 9-22-1305

Current through Register Vol. 30, No. 43, October 25, 2024

Section R9-22-1305 - CRS Redetermination

A. Continued eligibility for CRS services shall be redetermined by verifying active treatment status of the CRS qualifying medical condition(s) as follows:

1. The Ccontractor is responsible for notifying the AHCCCS Administration of the date when a member with a CRS Designation is no longer in active treatment for the qualifying condition(s).

2. The Administration may request, at any time, that the contractor submit the medical documentation to the Administration for a CRS medical redetermination within the specified time-frames in contract.

3. The Administration shall notify the member or authorized representative of the outcome of the redetermination.

B. If the Administration determines that a member is no longer medically eligible for a CRS Designation, the Administration shall provide the member or authorized representative a written notice that informs the member that the Administration is ending the member's CRS Designation. The member may appeal the redetermination under A.A.C. Title 9, Chapter 34.

C. Upon reaching his or her 21st birthday, the member's CRS Designation will be ended.

Ariz. Admin. Code § R9-22-1305

Adopted effective September 9, 1998 (Supp. 98-3). Amended by final rulemaking at 6 A.A.R. 3317, effective August 7, 2000 (Supp. 00-3). Section repealed by final rulemaking at 10 A.A.R. 808, effective April 3, 2004 (Supp. 04-1). Section made by exempt rulemaking at 18 A.A.R. 2074, effective August 1, 2012 (Supp. 12-3). New section made by final rulemaking at 19 A.A.R. 2954, effective November 10, 2013. Amended by final rulemaking at 24 A.A.R. 2855, effective 11/16/2018.