reglab/statecodes huggingface dataset:
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2956 - Liens on damages for injuries; notification

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 to whom hospital or medical service is rendered,  or to the legal representative of such person,  on account of injuries giving rise to such claims and which necessitated such hospital or medical care and treatment. Recovery of charges pursuant to this section shall be in a manner as nearly as possible the same as the procedures prescribed in sections 36-2915 and 36-2916.
B. The member or the member's legal representative must provide written notice to the administration within twenty calendar days after the commencement of a civil action or other proceeding to establish the liability of any third party or to collect monies payable from accident insurance,  liability insurance,  workers' compensation,  health insurance,  medical payment insurance,  underinsured coverage,  uninsured coverage or any other first or third party source.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2958 - Absence of federal financial participation; effect on system operation

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 program contractor of that fact. Neither the administration nor a program contractor shall provide services otherwise authorized by this article or be liable for the cost of services provided if federal monies are unavailable.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2959 - Reimbursement rates; capitation rates; annual review

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 shall also include a recommendation for annual inflationary costs. Unless modified in response to federal or state law,  the independent consulting firm shall include,  in its recommendation,  costs arising from amendments to existing contracts. The department may require,  and the department's contracted providers shall provide,  financial data to the department in the format prescribed by the department to assist in the study. A complete study of reimbursement rates shall be completed no less than once every five years.
B. Capitation rate adjustments shall be limited to utilization of existing services and inflation unless policy changes,  including creation or expansion of programs,  have been approved by the legislature or are specifically required by federal law or court mandate.
C. The administration 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 elderly and physical disability program of the Arizona long-term care system. The administration may require,  and the administration's contracted providers shall provide,  financial data to the administration in the format prescribed by the administration to assist in the study. A complete study of reimbursement rates shall be completed no less than once every five years. In determining the adequacy of the rates in the five year study,  the consulting firm shall examine in detail the costs associated with the delivery of services,  including programmatic,  administrative and indirect costs in providing services in rural and urban Arizona.
D. The department and the administration shall provide each of their reports to the joint legislative budget committee and the administration by October 1 of each year.
E. The department shall include the results of the study in its yearly capitation rate request to the administration.
F. If results of the study are not completely incorporated into the capitation rate,  the administration shall provide a report to the joint legislative budget committee within thirty days of setting the final capitation rate,  including reasons for differences between the rate and the study.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2960 - Persons with developmental disabilities; cost-effectiveness study rate; report

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 department shall report to the joint legislative budget committee the cost-effectiveness study rate for persons receiving developmental disability services that was determined for the subsequent fiscal year.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2972 - Rights, authority and responsibilities of the director and the administration

36-2972.
Rights,  authority and responsibilities of the director and the administration
A. Subject to continued federal financial participation as provided in sections 36-2919 and 36-2958,  the director shall plan for and take all steps necessary to implement the qualified medicare beneficiary program under title XIX of the social security act,  as amended.
B. The administration and the director have full operational responsibility for this article. Except as provided in this article or required by federal law or the section 1115 waiver,  the provisions of articles 1 and 2 of this chapter are fully applicable to this article and the director and administration have all the rights,  powers,  duties and responsibilities accorded to the system under articles 1 and 2 of this chapter. Services shall be delivered in accordance with federal law and the section 1115 waiver for articles 1 and 2 of this chapter.
C. The administration shall coordinate benefits provided under this article to members so that costs for services payable by the system are costs avoided or recovered from a third party payor. The director may require that program contractors,  contractors and noncontracting providers are responsible for the coordination of benefits for services provided pursuant to this article. Benefit coordination requirements for noncontracting providers are limited to coordination of benefits with standard health insurance and disability or medicare supplemental health insurance policies and similar programs for health coverage. The director shall require members to assign to the system rights to all types of medical benefits to which the member is entitled.
D. Notwithstanding section 36-2911,  the program contractors or contractors shall pay all premiums,  deductibles and coinsurance amounts for the member to obtain coverage or secure services as required by the administration. For members not enrolled with a contractor or program contractor the administration may pay the premiums,  deductibles and coinsurance amounts.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2973 - Qualified medicare beneficiary only; eligibility determination; application; enrollment

36-2973.
Qualified medicare beneficiary only;  eligibility determination;  application;  enrollment
A. The administration shall determine the eligibility of all applicants who may be eligible as qualified medicare beneficiaries only. The administration shall ensure that the calculation of income eligibility requirements is in accordance with federal law and the section 1115 waiver. On determination of qualified medicare beneficiary only eligibility,  the administration shall enroll the member in the system.
B. The administration may enroll the member who has been determined eligible as a qualified medicare beneficiary only in a fee-for-service arrangement. The director may enter into a contract with a medicare risk contractor that,  in accordance with section 1876 of the social security act,  has a contract with the health care financing administration and may pay premiums for enrollment of that member.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2974 - Dual eligibles; qualifications for coverage; enrollment

36-2974.
Dual eligibles;  qualifications for coverage;  enrollment
A. For purposes of this section all contractors and program contractors are required to provide services to members.
B. For a member who is dually eligible the director may implement a policy permitting a choice of contractors or program contractors to the extent the director deems feasible consistent with the section 1115 waiver and federal law. If the director does not implement a choice of contractor policy,  the director may enroll the member,  at the time eligibility is determined,  with an available contractor or program contractor located in the geographic area of the member's residence.
C. The department shall assist the administration in the screening of all persons who are applying to become eligible pursuant to section 36-2901,  paragraph 6,  subdivision (a) and who are entitled to services under title XVIII but not title XVI of the social security act to determine if the person meets the eligibility criteria of this section. If a person is determined to be eligible pursuant to section 36-2901,  paragraph 6,  subdivision (a) and this article,  the administration shall make the person dually eligible. On determination of dual eligibility the administration shall enroll the person pursuant to this article and notify the person of the dual eligibility.
D. The administration shall screen all persons who are entitled to services under title XVIII of the social security act and who are applying to become eligible pursuant to section 36-2901,  paragraph 6,  subdivision (a),  as prescribed by title XVI of the social security act or section 36-2931,  paragraph 5,  to determine if the person meets the eligibility criteria of this section. If a person is determined to be eligible pursuant to section 36-2901,  paragraph 6,  subdivision (a) or section 36-2931,  paragraph 5 and this article,  the administration shall make the person dually eligible. On determination of dual eligibility by the administration,  the administration shall enroll the person pursuant to this article and notify the person of the dual eligibility.
E. Calculation of income and resource eligibility requirements by the department and the administration pursuant to this section shall be in accordance with title XIX of the social security act,  as amended.
F. Program contractors and contractors shall pay medicare deductibles,  coinsurance and copayment amounts for services provided to dual eligibles pursuant to this article and as required by the administration for services that are provided by or under referral from a primary care physician or primary care practitioner.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2975 - Specified low income medicare beneficiary; eligibility

36-2975.
Specified low income medicare beneficiary;  eligibility
The administration shall determine the eligibility of all persons who are specified low income medicare beneficiaries in accordance with federal law. The administration shall pay the monthly premiums under part B of title XVIII of the social security act on behalf of each specified low income medicare beneficiary.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2976 - Qualifying individuals

36-2976.
Qualifying individuals
A. The administration shall determine the eligibility of all persons who are determined to be qualifying individuals pursuant to section 36-2971,  paragraphs 12 and 13.
B. The administration shall pay the medicare part B monthly premiums on behalf of each qualifying individual 1 and shall pay the medicare part B monthly amount that is attributable to home health coverage for each qualifying individual 2.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2981 - Definitions

36-2981.
Definitions
In this article,  unless the context otherwise requires:
1. " Administration"  means the Arizona health care cost containment system administration.
2. " Contractor"  means a health plan that contracts with the administration to provide hospitalization and medical care to members according to this article or a qualifying plan.
3. " Director"  means the director of the administration.
4. " Federal poverty level"  means the federal poverty level guidelines published annually by the United States department of health and human services.
5. " Health plan"  means an entity that contracts with the administration for services provided pursuant to article 1 of this chapter.
6. " Member"  means a person who is eligible for and enrolled in the program,  who is under nineteen years of age and whose gross household income meets the following requirements:
(a) Beginning on October 1,  1999 through September 30,  2023,  has income at or below two hundred percent of the federal poverty level.
(b) Beginning on October 1,  2023 and for each fiscal year thereafter,  subject to the approval of the centers for medicare and medicaid services,  has income at or below two hundred twenty-five percent of the federal poverty level.
7. " Noncontracting provider"  means an entity that provides hospital or medical care but does not have a contract or subcontract with the administration.
8. " Physician"  means a person who is licensed pursuant to title 32,  chapter 13 or 17.
9. " Prepaid capitated"  means a method of payment by which a contractor delivers health care services for the duration of a contract to a specified number of members based on a fixed rate per member,  per month without regard to the number of members who receive care or the amount of health care services provided to a member.
10. " Primary care physician"  means a physician who is a family practitioner,  general practitioner,  pediatrician,  general internist,  obstetrician or gynecologist.
11. " Primary care practitioner"  means a nurse practitioner who is certified pursuant to title 32,  chapter 15 or a physician assistant who is licensed pursuant to title 32,  chapter 25 and who is acting within the respective scope of practice of those chapters.
12. " Program"  means the children's health insurance program.
13. " Qualifying plan"  means a contractor that contracts with the state pursuant to section 38-651 to provide health and accident insurance for state employees and that provides services to members pursuant to section 36-2989,  subsection A.
14. " Special health care district"  means a special health care district organized pursuant to title 48,  chapter 31.
15. " Tribal facility"  means a facility that is operated by an Indian tribe and that is authorized to provide services pursuant to Public Law 93-638,  as amended.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2985 - Notice of program suspension; spending limit

36-2985.
Notice of program suspension;  spending limit
A. If the director determines that federal and state monies appropriated for the program are insufficient,  the administration shall immediately notify the governor,  the president of the senate and the speaker of the house of representatives and may stop processing all new applications.
B. The total amount of state monies that the administration may spend in any fiscal year for health care provided under this article shall not exceed the amount appropriated or authorized by section 35-173.
C. This article does not impose a duty on an officer,  agent or employee of this state to discharge a responsibility or create any right in a person or group if the discharge or right would require an expenditure of state monies in excess of the expenditure authorized by legislative appropriation for that specific purpose.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2990 - Quality of health care monitoring standard; development; adoption; use; additional monitoring; costs

36-2990.
Quality of health care monitoring standard;  development;  adoption;  use;  additional monitoring;  costs
A. The administration shall develop standards of care that each contractor shall use to monitor the quality of health care received by members.
B. The director shall periodically determine whether each contractor has properly adopted and implemented standards to ensure the quality of health care. If the director determines that a contractor is out of compliance,  the director shall undertake additional efforts to monitor and assess the quality of health care provided by that contractor for the period of time that the director deems necessary. The director shall determine the cost incurred in undertaking these special efforts and shall deduct that amount from any payment owed to the contractor.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2991 - Fraud; penalties; enforcement; violation; classification

36-2991.
Fraud;  penalties;  enforcement;  violation;  classification
A. A person shall not provide or cause to be provided false or fraudulent information on an application for eligibility pursuant to this article.
B. A person who violates subsection A of this section,  who is determined eligible for services pursuant to this article and who would have been determined ineligible if the person had provided true and correct information is subject,  in addition to any other penalties that may be prescribed by federal or state law,  to a civil penalty of not more than the amount incurred by the system,  including capitation payments made on behalf of the person. In addition,  the person's eligibility may be discontinued in accordance with rules adopted by the director.
C. In addition to the requirements of state law,  any applicable fraud and abuse controls that are enacted under federal law apply to persons who are eligible for services under this article and to contractors and noncontracting providers who provide services under this article.
D. The director shall make the determination to assess a civil penalty and is responsible for collection of the penalty. The director may adopt rules that prescribe procedures for the determination and collection of civil penalties. The director may compromise civil penalties imposed under this section in accordance with criteria established in rules.
E. The director shall adopt rules providing for the appeal of a decision by a person adversely affected by a determination made by the director under this section. The director's final decision is subject to judicial review pursuant to title 12,  chapter 7,  article 6.
F. Amounts paid by the state and recovered under this section shall be deposited in the state general fund,  and any applicable federal share shall be returned to the United States department of health and human services.
G. If a civil penalty imposed pursuant to subsection D of this section is not paid,  the state may file an action to collect the civil penalty in the superior court in Maricopa county. Matters that were raised or could have been raised in a hearing before the director or in an appeal pursuant to title 12,  chapter 7,  article 6 may not be raised as a defense to the civil action. An action brought pursuant to this subsection shall be initiated within six years after the date the claim is presented.
H. A person who knowingly aids or abets another person pursuant to section 13-301,  13-302 or 13-303 in the commission of an offense under this section or section 13-3713 is guilty of a class 5 felony.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2992 - Duty to report fraud or abuse; immunity; unprofessional conduct

36-2992.
Duty to report fraud or abuse;  immunity;  unprofessional conduct
A. All contractors and noncontracting providers shall advise the director or the director's designee immediately in a written report of any cases of suspected fraud or abuse. The director shall review the report and conduct a preliminary investigation to determine if there is a sufficient basis to warrant a full investigation. If the findings of a preliminary investigation give the director reason to believe that an incident of fraud or abuse has occurred,  the matter shall be referred to the attorney general.
B. Any person making a complaint or furnishing a report,  information or records in good faith pursuant to this section is immune from any civil liability by reason of that action unless that person has been charged with or is suspected of the reported fraud or abuse.
C. Any health care provider who fails to report pursuant to this section commits an act of unprofessional conduct and is subject to disciplinary action by the provider's licensing board or department.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2994 - Monthly financial report

36-2994.
Monthly financial report
A. The director shall include in the monthly report submitted to the president of the senate and the speaker of the house of representatives pursuant to section 36-2920 the following information about the program:
1. The actual year to date expenditures and projected annual expenditures.
2. The actual member months.
3. Monies recovered monthly from third party payors.
4. The amount and origin of any donation or grant from a private entity and the impact on the implementation of the program.
B. The report shall be submitted on or before the twenty-fifth day of the following month.
C. The director shall provide a copy of the monthly report to the chairmen of the house of representatives and senate standing committees on appropriations and health.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2995 - Children's health insurance program fund; sources of monies; use; reversion; claims

36-2995.
Children's health insurance program fund;  sources of monies;  use;  reversion;  claims
A. The children's health insurance program fund is established. The administration shall administer the fund and shall use fund monies to pay administrative and program costs associated with the operation of the program established by this article.
B. Separate accounting shall be made for each source of monies received pursuant to subsection C of this section for expenses and income activity associated with the program established pursuant to this article.
C. Monies in the fund are comprised of:
1. Federal monies available to this state for the operation of the program.
2. Tobacco tax and state general fund monies appropriated as state matching monies.
3. Gifts,  donations and grants from any source.
4. Interest paid on monies deposited in the fund.
5. Third party liability recoveries.
D. If a gift,  a donation or a grant of over ten thousand dollars received from any private source contains a condition,  the administration shall first meet with the joint legislative study committee on the integration of health care services to review the condition before it spends that gift,  donation or grant.
E. All monies in the fund other than monies appropriated by this state do not lapse.
F. Monies appropriated from the medically needy account of the tobacco tax and health care fund are exempt from section 35-190 relating to lapsing of appropriations. Notwithstanding section 35-191,  subsection B,  the period for administrative adjustments extends for only six months for appropriations made for administration covered services.
G. Notwithstanding sections 35-190 and 35-191,  all approved claims for system covered services presented after the end of the fiscal year in which they were incurred shall be paid either in accordance with this section or in the current fiscal year with the monies available in the funds established by this section.
H. Claims for covered services that are determined to be valid by the director and the grievance and appeal procedure shall be paid from the children's health insurance program fund.
I. All payments for claims from the children's health insurance program fund shall be accounted for by the administration by the fiscal year in which the claims were incurred,  regardless of the fiscal year in which the payments were made.
J. Notwithstanding any other law,  county owned or contracted providers and special health care district owned or contracted providers are subject to all claims processing and payment requirements or limitations of this chapter that are applicable to noncounty providers.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2998 - Qualifying plans

36-2998.
Qualifying plans
A. A qualifying plan,  as defined in section 36-2981,  may elect to participate in the children's health insurance program established pursuant to this article,  subject to all requirements established in this article and in accordance with section 36-2989.
B. The director of the Arizona health care cost containment system shall establish the terms and conditions that shall be used to exercise the option to participate.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.51 - Definitions

36-2999.51.
Definitions
(Rpld. 10/1/31)
In this article,  unless the context otherwise requires:
1. " Continuing care retirement community"  means an entity that provides nursing facility services and assisted living or independent living services on a contiguous campus that is either registered as a life care facility with the department of insurance and financial institutions or has assisted living and independent living beds in the aggregate that equal at least twice the number of nursing facility beds. For the purposes of this paragraph,  " contiguous"  means land that adjoins or touches the other property held by the same or a related organization and land divided by a public road.
2. " Fiscal year"  means the period beginning on October 1 and ending on September 30.
3. " Medicare resident days"  means resident days that are funded by the medicare program,  a medicare advantage or special needs plan or the medicare hospice program.
4. " Net patient service revenue"  means gross inpatient revenues from services that are provided to nursing facility patients minus reductions from gross inpatient revenue. For the purposes of this paragraph,  inpatient revenues from services do not include nonpatient care revenues such as beauty and barber income,  vending income,  interest and contributions,  revenues from the sale of meals and all outpatient revenues.
5. " Nursing facility"  means a health care institution that provides inpatient beds or resident beds and nursing services to persons who need nursing services on a continuing basis but who do not require hospital care or direct daily care from a physician. Nursing facility does not include the Arizona veterans' homes.
6. " Reductions from gross inpatient revenue"  includes bad debts,  contractual adjustments,  uncompensated care,  administrative,  courtesy and policy discounts,  adjustments and other similar revenue deductions.
7. " Resident day"  means a calendar day of care provided to a nursing facility resident,  including the day of admission and excluding the day of discharge. Resident day includes a day on which a bed is held for a patient and for which the facility receives compensation for holding the bed.
8. " Upper payment limit"  means the limitation established pursuant to 42 Code of Federal Regulations section 447.272 that disallows federal matching funds if a state medicaid agency pays certain classes of nursing facilities an aggregate amount for services that would exceed the amount that would be paid for the same services furnished by that class of nursing facilities under medicare payment principles.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.52 - Nursing facility quality assessments; calculation; limitation; exceptions

36-2999.52.
Nursing facility quality assessments;  calculation;  limitation;  exceptions
(Rpld. 10/1/31)
A. Beginning October 1,  2012,  the administration shall charge a quality assessment on health care items and services provided by nursing facilities in order to obtain federal financial participation in the services provided pursuant to this chapter. The administration shall use these monies for supplemental payments to nursing facilities for covered medicaid expenditures,  not to exceed the medicare upper payment limit program requirements.
B. Each nursing facility shall pay the assessment prescribed pursuant to this section to the department of revenue for deposit on a quarterly basis in the nursing facility assessment fund established by section 36-2999.53.
C. Unless otherwise required by law,  title 42,  chapter 5,  article 1 governs the administration of the assessment prescribed pursuant to this section except that:
1. A separate license is not required for the assessment.
2. If a nursing facility does not have a transaction privilege tax license,  it shall obtain one pursuant to section 42-5005.
3. Each facility shall report and pay the assessment on forms prescribed by the department of revenue.
4. A separate bond is not required of employees of the department of revenue who administer the assessment.
5. The assessment may be included without segregation in any notice and lien filed for unpaid transaction privilege taxes.
D. The administration shall calculate the quality assessment on the net patient service revenue of all nursing facilities that are subject to the quality assessment. The quality assessment may not exceed three and one-half per cent of net patient service revenue and shall be calculated and paid on a per resident day basis exclusive of medicare resident days. Except as prescribed in this section,  the per resident day assessment is the same amount for each affected facility.
E. Pursuant to 42 Code of Federal Regulations section 433.68(e)(1) and (2),  the administration shall request a waiver of the broad-based and uniform provider assessment requirements of federal law to exclude certain nursing facilities from the quality assessment and to permit certain high volume medicaid nursing facilities or facilities with a high number of total annual patient days to pay the quality assessment at a lesser amount per nonmedicare resident day.
F. Subject to federal approval pursuant to 42 Code of Federal Regulations section 433.68(e)(2),  the following nursing facility providers are exempt from the quality assessment:
1. Continuing care retirement communities.
2. Nursing facilities with fifty-eight or fewer beds.
G. The administration shall lower the quality assessment for either certain high volume medicaid nursing facilities or certain facilities with high patient volumes to meet the redistributive test of 42 Code of Federal Regulations section 433.68(e)(2).
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.53 - Nursing facility assessment fund

36-2999.53.
Nursing facility assessment fund
(Rpld. 10/1/31)
A. The nursing facility assessment fund is established consisting of the following:
1. Monies received by the administration from nursing facility assessments pursuant to this article.
2. Federal monies and federal matching monies received by the administration as a result of expenditures made by the administration that are attributable to monies deposited in the fund.
3. Interest or penalties collected pursuant to this article.
4. Legislative appropriations.
5. Private grants,  gifts,  contributions and devises from any source received to assist in carrying out the purposes of this article.
B. The administration shall administer the fund. Monies in the fund are continuously appropriated.
C. The administration shall use fund monies only for the following:
1. To qualify for federal matching funds for supplemental payments for nursing facility services within medicare upper payment limit program requirements.
2. To pay administrative expenses incurred by the administration or its agents in performing the activities authorized by this chapter,  provided that these expenses may not exceed one per cent of the aggregate assessment funds collected for the fiscal year.
3. To reimburse the medicaid sharer of the quality assessment.
4. To provide medicaid supplemental payments to fund covered services to nursing facility medicaid beneficiaries within medicare upper payment limits.
D. On notice from the administration,  the state treasurer shall invest and divest monies in the fund as provided by section 35-313,  and monies earned from investment shall be credited to the fund.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.54 - Assessments; failure to pay; suspension or revocation

36-2999.54.
Assessments;  failure to pay;  suspension or revocation
(Rpld. 10/1/31)
A. Each nursing facility shall pay a quality assessment as prescribed pursuant to this article. The administration shall determine the assessment rate prospectively for the applicable fiscal year on a per resident day basis,  exclusive of medicare resident days. The administration shall adopt rules for facility reporting of nonmedicare resident days and for payment of the assessment.
B. A nursing facility may increase its charges to other payors to incorporate the assessment but may not establish a separate line-item charge on the bill reflecting the assessment.
C. If an entity conducts,  operates or maintains more than one nursing facility,  the entity must pay a quality assessment for each nursing facility separately.
D. If a nursing facility does not pay the full amount of the assessment when due,  the director of the Arizona health care cost containment system administration may suspend or revoke the nursing facility's Arizona health care cost containment system provider agreement registration. If the nursing facility does not comply within one hundred eighty days after the director of the Arizona health care cost containment system administration suspends or revokes the nursing facility's provider agreement,  the director of the Arizona health care cost containment system administration shall notify the director of the department of health services,  who shall suspend or revoke the nursing facility's license pursuant to section 36-427.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.55 - Adjustment of payments; definition

36-2999.55.
Adjustment of payments;  definition
(Rpld. 10/1/31)
A. A nursing facility is eligible for quarterly nursing facility adjustments based on nursing facility days from the most recent cost report before the start of the fiscal year. If cost report data is unavailable for a nursing facility,  the administration may use other data sources or request patient day information from the facility to estimate nursing facility days.
B. The administration shall make adjustment payments on a quarterly basis to reimburse the medicaid portion of the assessment and other covered medicaid expenditures in the aggregate within the upper payment limit. Each quarterly payment shall be made not later than thirty days after the end of the calendar quarter with the initial adjustment payment due within thirty days after approval by the centers for medicare and medicaid services of the quality assessment waiver and state plan reflecting the nursing facility adjusted payments.
C. Subject to approval by the centers for medicare and medicaid services,  a nursing facility that is located outside of this state may not receive payments pursuant to this article.
D. For the purposes of this section,  " nursing facility days"  means the days of nursing facility services,  including bed hold days,  paid for by the Arizona medical assistance program for the applicable state fiscal year.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.56 - Modifications

36-2999.56.
Modifications
(Rpld. 10/1/31)
The administration may modify the categories of facilities exempt from the quality assessment and the rate adjustment provisions of this article if this is necessary to obtain and maintain approval by the centers for medicare and medicaid services and if the modification is consistent with purposes of this article.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.57 - Discontinuance of assessments

36-2999.57.
Discontinuance of assessments
(Rpld. 10/1/31)
A. The department of revenue shall discontinue collection of all assessments if any of the following applies:
1. The quality assessment waiver or the state plan amendment reflecting the quarterly nursing facility adjustment payments is not approved by the centers for medicare and medicaid services.
2. The administration reduces funding for nursing facility services below the state appropriation in effect on the effective date of this article.
3. The administration or any other state agency attempts to use monies in the nursing facility assessment fund established pursuant to section 36-2999.53 for any use other than those permitted pursuant to this article.
4. Federal financial participation to match the quality assessments made pursuant to this article becomes unavailable under federal law,  in which case the administration must terminate the imposition of the assessments beginning on the date the federal statutory,  regulatory or interpretive changes take effect.
B. If the department of revenue discontinues collection of the assessment pursuant to this section,  it shall return all monies in the nursing facility assessment fund established by section 36-2999.53 to the nursing facilities from which the assessment was collected on the same basis as the assessments were assessed.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.71 - Definitions

36-2999.71.
Definitions
(Conditionally Rpld.)
In this article,  unless the context otherwise requires:
1. " Administration"  has the same meaning prescribed in section 36-2901.
2. " Base reimbursement level" :
(a) Means the total expenditures by the Arizona health care cost containment system and its contracted health plans for hospital services to eligible persons in state fiscal year 2019-2020.
(b) Does not include directed payments made pursuant to this article or payments made through the pediatric services initiative pursuant to 42 Code of Federal Regulations section 438.6(c).
3. " Director"  has the same meaning prescribed in section 36-2901.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-2999.72 - Hospital assessment; rules; collection; enforcement

36-2999.72.
Hospital assessment;  rules;  collection;  enforcement
(Conditionally Rpld.)
A. In addition to the assessment established pursuant to section 36-2901.08,  beginning October 1,  2020,  the director shall establish,  administer and collect an assessment on hospital revenues,  discharges or bed days with respect to inpatient or outpatient services,  or both,  for the purposes prescribed in section 36-2999.73.
B. The director shall adopt rules regarding the method for determining the assessment,  the amount or rate of the assessment and modifications to or exemptions from the assessment. The assessment is subject to approval by the centers for medicare and medicaid services to ensure that the assessment is not established or administered in a manner that causes a reduction in federal financial participation.
C. The director may establish modifications to or exemptions from the assessment. In determining the modifications or exemptions,  the director may consider such factors as the size of the hospital,  the specialty services available to patients at the hospital and the geographic location of the hospital.
D. The director shall present any change to the hospital assessment methodology to the joint legislative budget committee for review.
E. The administration shall deposit,  pursuant to sections 35-146 and 35-147,  the monies collected pursuant to this section in the health care investment fund established by section 36-2999.73.
F. A hospital may not pass the cost of the assessment on to patients or third-party payors that are liable to pay for care on a patient's behalf. As part of its financial statement submissions pursuant to section 36-125.04,  a hospital shall submit to the department of health services an attestation that it has not passed on the cost of the assessment to patients or third-party payors.
G. If a hospital does not comply with this section as prescribed by the director of the Arizona health care cost containment system,  the director of the Arizona health care cost containment system may suspend or revoke the hospital's Arizona health care cost containment system provider agreement registration. If the hospital does not comply within one hundred eighty days after the director of the Arizona health care cost containment system suspends or revokes the hospital's provider agreement,  the director of the Arizona health care cost containment system shall notify the director of the department of health services,  who shall suspend or revoke the hospital's license pursuant to section 36-427.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-3001 - Definitions

36-3001.
Definitions
In this chapter,  unless the context otherwise requires:
1. " Administration"  means the community services administration in the department of economic security.
2. " Domestic violence"  means attempting to cause or causing bodily injury to a family or household member or placing a family or household member by threat of force in fear of imminent physical harm.
3. " Domestic violence service provider"  means a facility whose primary purpose is to provide services to family or household members who are victims of domestic violence,  including:
(a) Shelter for victims of domestic violence.
(b) Domestic violence victim advocacy.
(c) Other support services for domestic violence victims.
4. " Family or household member"  means a spouse,  a former spouse,  a parent,  a child or another adult person related by consanguinity or affinity who is residing or has resided or has a child or children in common with the person committing the domestic violence and dependents of such persons.
5. " Fund"  means the domestic violence services fund.
6. " Program administrator"  means the program administrator of the community services administration in the department of economic security.
7. " Shelter for victims of domestic violence"  or " shelter"  means a facility providing temporary residential service or facilities to family or household members who are victims of domestic violence.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-3002 - Domestic violence services fund; purpose

36-3002.
Domestic violence services fund;  purpose
A. The domestic violence services fund is established consisting of monies received pursuant to section 12-116.06,  section 12-284.03,  subsection A,  paragraph 2,  section 41-178 and section 43-618. The program administrator shall administer the fund for the purposes prescribed in this section.
B. The department of economic security,  after full consultation with a statewide coalition against domestic violence,  shall establish program priorities for the fund. Subject to legislative appropriation,  the department shall expend monies in the fund to provide financial assistance to service providers for victims of domestic violence through contracts for services.
C. Monies in the fund do not revert to the state general fund.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-3005 - Domestic violence service provider requirements for eligibility

36-3005.
Domestic violence service provider requirements for eligibility
A. To be eligible to receive fund monies under this chapter,  a domestic violence service provider shall adhere to statewide service standards for domestic violence programs that are approved by the department of economic security in collaboration with a state coalition against domestic violence.
B. A domestic violence service provider does not qualify for fund monies if it discriminates in its admissions or provision of services on the basis of race,  religion,  color,  age,  disability,  marital status,  national origin or ancestry.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-3006 - Methodology for allocation of fund monies

36-3006.
Methodology for allocation of fund monies
After full consultation with a state coalition against domestic violence,  the department shall develop a weighted methodology for allocation of funding that considers the following:
1. The need for services.
2. Existing services.
3. Geographic location.
4. Population ratios.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-3007 - Annual report

36-3007.
Annual report
A. The department of economic security shall file an annual report with the governor,  the speaker of the house of representatives and the president of the senate on or before October 1 and shall provide a copy of this report to the secretary of state. In preparing the report the department shall fully consult with a state coalition against domestic violence.
B. The report shall include the following information from each domestic violence service provider that receives monies pursuant to this chapter:
1. The population served.
2. The services provided.
3. The unmet needs of persons who receive services.
C. Information contained in the report shall not identify any person served by a service provider or enable any person to determine the identity of any such person.
2023 Arizona Revised Statutes › Title 36 - Public Health and Safety › § 36-3008 - Services for victims of domestic violence; personnel; fingerprinting; confidentiality; notification

36-3008.
Services for victims of domestic violence;  personnel;  fingerprinting;  confidentiality;  notification
A. Employees and volunteers of a domestic violence service provider shall have valid fingerprint clearance cards that are issued pursuant to title 41,  chapter 12,  article 3.1 or shall apply for a fingerprint clearance card within seven working days of employment or beginning volunteer work. Federally recognized Indian tribes or military bases may submit and the department shall accept certifications that state that employees of a domestic violence service provider who are employed by a domestic violence service provider and who provide services directly to victims of domestic violence have not been convicted of,  have not admitted committing or are not awaiting trial on any offense under subsection B,  paragraph 1 of this section.
B. Personnel shall certify on forms that are provided by the department and notarized that:
1. They are not awaiting trial on and have never been convicted of or admitted committing any of the criminal offenses listed in section 41-1758.03,  subsections B and C in this state or similar offenses in another state or jurisdiction.
2. They have not been denied a license to operate a facility that provides services for domestic violence victims in this state or another state or had a license to operate a facility that provides services for domestic violence victims revoked.
C. The notarized forms are confidential.
D. The domestic violence service provider shall make good faith efforts to contact previous employers to obtain information or recommendations that may be relevant to an individual's fitness to work for the provider.
E. A domestic violence service provider shall notify the department of public safety if the provider receives credible evidence that a person who possesses a fingerprint clearance card either:
1. Is arrested for or charged with an offense listed in section 41-1758.03,  subsection B.
2. Falsified information on the form required by subsection B of this section.