Ariz. Admin. Code § 9-28-1101
Current through Register Vol. 30, No. 50, December 13, 2024
Section R9-28-1101 - General RequirementsGeneral requirements. The following general requirements apply to behavioral health services provided under this Article, and Chapter 22 subject to all exclusions and limitations.
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1. Definitions. The definitions in A.A.C. R9-22-1201 and R9-22-101 apply to this Article, in addition to the following definitions:"Case manager" means an individual responsible for coordinating the physical health services or behavioral health services provided to a patient at the health care institution.
"Contractor" means an ALTCS contractor or as previously known as program contractor. "Cost avoid" means the same as in A.A.C. R9-22-1201.
"Intergovernmental agreement" or "IGA" means an agreement for services or joint or cooperative action between the Administration and a tribal contractor.
"Qualified behavioral health service provider" means a behavioral health service provider that meets the requirements of R9-28-1106.
"Tribal contractor" means a tribal organization (The Tribe) or urban Indian organization defined in 25 U.S.C. 1603 and recognized by CMS as meeting the requirements of 42 U.S.C. 1396 d(b), that provides or is accountable for providing the services or delivering the items described in the intergovernmental agreement.
2. Case management. A tribal contractor shall provide case management services to FFS American Indian members living on or off-reservation as delineated in the IGA.3. Reimbursement. For FFS American Indians, the Administration is exclusively responsible for providing reimbursement for covered behavioral health services that are authorized by a tribal contractor or the Administration under the intergovernmental agreement as specified in this Article. A contractor is exclusively responsible for providing reimbursement for covered behavioral health services that are authorized by a contractor as specified in this Article.Ariz. Admin. Code § R9-28-1101
Adopted under an exemption from A.R.S. Title 41, Chapter 6, pursuant to Laws 1992, Ch. 301, §61, effective November 1, 1992; received in the Office of the Secretary of State November 25, 1992 (Supp. 92-4). Section repealed; new Section adopted by final rulemaking at 6 A.A.R. 200, effective December 13, 1999 (Supp. 99-4). Amended by exempt rulemaking at 7 A.A.R. 4691, effective October 1, 2001 (Supp. 01-3). Amended by final rulemaking at 13 A.A.R. 1090, effective May 5, 2007 (Supp. 07-1). Amended by final rulemaking at 20 A.A.R. 3122, effective 1/4/2015.