Ariz. Admin. Code § 9-34-316

Current through Register Vol. 30, No. 25, June 21, 2024

Section R9-34-316 - Request for Expedited Resolution of an Appeal

A. AHCCCS shall mail a Notice of State Fair Hearing under A.R.S. § 41-1092.05 when AHCCCS receives an appeal request from an FFS member no later than 30 days after the FFS member receives the AHCCCS Notice of Action and:

1. AHCCCS determines that taking the time for a standard resolution could seriously jeopardize the FFS member's life, health, or ability to attain, maintain, or regain maximum function;

2. The expedited appeal request is supported with documentation by the provider supporting that taking the time for a standard resolution could seriously jeopardize the FFS member's life or health, or ability to attain, maintain, or regain maximum function; or

3. AHCCCS receives an expedited appeal request directly from the provider who indicates that taking the time for a standard resolution could seriously jeopardize the FFS member's life or health, or ability to attain, maintain, or regain maximum function.

B. AHCCCS shall ensure that punitive action is not taken against a provider who requests an expedited resolution or who supports an FFS member's appeal.

C. If AHCCCS denies a request for expedited resolution of an appeal from an FFS member, AHCCCS shall:

1. Resolve the appeal within the time-frame in R9-34-315, and

2. Make reasonable efforts to give the FFS member prompt oral notice of the denial, and follow up within two calendar days with a written notice.

D. If an FFS member wants services to be continued pending a State Fair Hearing, the request to continue services shall be in writing and comply with R9-34-321.

Ariz. Admin. Code § R9-34-316

New Section made by final rulemaking at 10 A.A.R. 828, effective April 3, 2004 (Supp. 04-1).