reglab/statecodes huggingface dataset:
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 23 - THRESHOLD RATE REVIEW - INDIVIDUAL HEALTH INSURANCE › Section R20-6-2305 - Threshold Rate Increase Documentation Requirements

Current through Register Vol. 30, No. 28, July 12, 2024
A. For a threshold rate increase, a health
				insurer shall submit to the Department documentation that is sufficient to
				allow the Department to assess:
1. The
				reasonableness of the assumptions used by the health insurer to develop the
				proposed rate increase and the validity of the historical data underlying the
				assumptions, and
2. The health
				insurer's data related to past projections and actual experience.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 24 - OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION › Section R20-6-2401 - Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
The definitions in A.R.S. §
									20-3111 and this Section apply to
				  this Article.
1. "Allowed Amount" is
				the amount reimbursable for a covered service under the terms of the enrollee's
				benefit plan. The allowed amount includes both the amount payable by the
				insurer and the amount of the enrollee's cost sharing requirements.
2. "Alternative Arbitrator" is an individual
				who is mutually agreeable to the health insurer and health care provider to act
				as the arbitrator of a surprise out-of-network billing dispute. If the person
				is contracted with the State of Arizona to conduct arbitration proceedings, the
				provisions of that contract shall apply. Department staff may not serve as an
				Alternative Arbitrator.
3. "Amount
				of the enrollee's cost sharing requirements" means the amount determined by the
				insurer prior to the dispute resolution process to be owed by the enrollee for
				out-of-network copayment, coinsurance and deductible pursuant to the enrollee's
				health care policy.
4. "Arbitrator"
				has the same meaning as A.R.S. §
									20-3111(2)  and
				may include a mediator, arbitrator or other alternative dispute resolution
				professional who is contracted with the Department to arbitrate a surprise
				out-of-network billing dispute. Department staff may not serve as an
				Arbitrator.
5. "A.R.S. §
									20-3113 Disclosure" means a
				written, dated document that contains the following information:
a. The name of the billing health care
				provider;
b. A statement that the
				health care provider is not a contracted provider;
c. The estimated total cost to be billed by
				the health care provider or the provider's representative for the health care
				services being provided;
d. A
				notice that the enrollee or the enrollee's authorized representative is not
				required to sign the A.R.S. §
										20-3113 Disclosure to obtain
				health care services;
e. A notice
				that if the enrollee or the enrollee's authorized representative signs the
				A.R.S. §
										20-3113 Disclosure, they may have
				waived any rights to request arbitration of a qualifying surprise
				out-of-network bill.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 24 - OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION › Section R20-6-2402 - Request for Arbitration

Current through Register Vol. 30, No. 28, July 12, 2024
A. Request
				for Arbitration. An enrollee may request dispute resolution of a surprise
				out-of-network bill by filing a timely Request for Arbitration with the
				Department on a Request for Arbitration form available on the Department's
				website.
B. Deadline for filing a
				Request for Arbitration with the Department. A Request for Arbitration must be
				received by the Department within one year after the date of service listed on
				the surprise out-of-network bill. If the enrollee filed a health care appeal
				pursuant to A.R.S. Title 20, Chapter 15, Article 2, the one year deadline is
				tolled from the date the enrollee filed the health care appeal to the date of
				the final resolution of the appeal.
C. Evaluation of the Request for Arbitration
				by the Department. Within 15 days after receipt of a Request for Arbitration,
				the Department shall do one of the following:
1. Determine that the surprise out-of-network
				bill is a qualifying surprise out-of-network bill and notify the enrollee,
				health insurer and health care provider that the Request for Arbitration
				qualifies for Arbitration;
2.
				Determine that the surprise out-of-network bill is not a qualifying surprise
				out-of-network bill and notify the enrollee of the reason for the Department's
				determination;
3. Determine that
				the Request for Arbitration is incomplete, or
4. Return the Request for Arbitration to the
				enrollee without making a determination if the enrollee's request should
				instead be filed as a health care appeal within the meaning of A.R.S. Title 20,
				Chapter 15, Article 2.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 24 - OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION › Section R20-6-2403 - Informal Settlement Teleconference

Current through Register Vol. 30, No. 28, July 12, 2024
A. Deadline to arrange the Informal
				Settlement Teleconference. Upon a determination that an enrollee has made a
				Request for Arbitration that qualifies for Arbitration, the Department shall
				arrange an Informal Settlement Teleconference between the parties within 30
				days of notifying the enrollee that the enrollee's Request for Arbitration
				qualifies for Arbitration required by Section R20-6-2402(C)(1).
B. Notice of Informal Settlement
				Teleconference. At least 14 days prior to the scheduled date, the Department
				shall send a Notice of Informal Settlement Teleconference to the enrollee, the
				enrollee's authorized representative, the health insurer, the health care
				provider and the health care provider's representative informing them of the
				date, time and instructions on how to participate in the Informal Settlement
				Teleconference.
C. Health Insurer
				documentation. On or before the Informal Settlement Teleconference, the health
				insurer shall provide to the parties the enrollee's cost sharing requirements
				under the enrollee's health plan based on the qualifying surprise
				out-of-network bill.
D.
				Consequences of non-participation in the Informal Settlement Teleconference. If
				a party fails to participate in the Informal Settlement Teleconference, it
				shall be subject to the following consequences:
1. If the health insurer, provider or
				provider's representative fails to participate in an Informal Settlement
				Teleconference scheduled by the Department, the participating party may notify
				the Department which shall promptly schedule the Arbitration. The
				non-participating party shall pay the entire cost of the Arbitration.
2. If the enrollee or the enrollee's
				authorized representative fails to participate in the original Informal
				Settlement Teleconference, the original Informal Settlement Teleconference is
				terminated.
3. If the enrollee or
				the enrollee's authorized representative fails to participate in a rescheduled
				Informal Settlement Teleconference, the enrollee's Request for Arbitration is
				terminated.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 24 - OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION › Section R20-6-2404 - Arbitrators

Current through Register Vol. 30, No. 28, July 12, 2024
A. Contracted
				entities. The Department shall contract with one or more persons to provide
				Arbitrators. The Department must have a list of at least four Arbitrators to
				assign to Arbitrations. The Department shall publish the list of contracted
				entities and a list of each entity's qualified Arbitrators on its
				website.
B. Arbitrator
				Qualifications. Any person contracting with the Department must be able to
				provide Arbitrators who possess at least three years of experience in health
				care services claims.
C.
				Alternative Arbitrators. A health insurer and provider may mutually agree to
				use an Alternative Arbitrator if either the health insurer or the health care
				provider objects to an Arbitrator appointed by the Department.
D. Appointment of an Arbitrator.
1. The Department shall appoint an Arbitrator
				for each Arbitration.
2. If the
				health insurer and health care provider do not agree to the Arbitrator
				appointed by the Department, they shall either:
a. Mutually agree to use an Alternative
				Arbitrator; or
b. Participate in
				the following procedure:
i. The Department
				shall assign three Arbitrators.
ii. The health insurer shall strike one
				Arbitrator.
iii. The health care
				provider shall strike one Arbitrator.
iv. If one Arbitrator remains, the Department
				shall appoint the remaining Arbitrator to the Arbitration.
v. If the health insurer and health care
				provider strike the same Arbitrator, the Department shall randomly assign the
				Arbitrator from the remaining two Arbitrators.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 24 - OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION › Section R20-6-2405 - Before the Arbitration

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				Enrollee's duties. Before the Arbitration, the enrollee shall:
1. Pay or make arrangements in writing to pay
				to the health care provider the amount stated by the health insurer in the
				Informal Settlement Teleconference which shall be the total amount of the
				enrollee's cost sharing requirements due for the health care services that are
				the subject of the qualifying surprise out-of-network bill.
2. Pay to the health care provider any amount
				that the enrollee has received from the health insurer as payment for the
				health care services that are the subject of the qualifying surprise
				out-of-network bill.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 24 - OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION › Section R20-6-2406 - The Arbitration

Current through Register Vol. 30, No. 28, July 12, 2024
A. Conduct
				of Arbitration. An Arbitration of a qualifying out-of-network surprise bill
				shall be conducted:
1. Telephonically unless
				the parties agree otherwise;
2.
				With or without the enrollee's participation;
3. Within 120 days after the Department's
				Notice of Arbitration unless agreed otherwise by the parties; and
4. For a maximum duration of four hours
				unless agreed otherwise by the parties.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 08 - Greater Arizona Development Authority › Article 1 - TECHNICAL ASSISTANCE › Section R20-8-101 - Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
In addition to the definitions prescribed in A.R.S. §
									41-2251,
				  the following definitions apply in this Article:
"Administrative fee" means any and all costs or expenses
				  associated with processing, preparing or executing a technical assistance
				  application or related transaction, including costs and expenses associated
				  with staff, the Board, professional services, service providers, vendors or
				  other entities involved in the transaction.
"Administratively complete" means that an applicant has
				  completed the application for technical assistance and provided all of the
				  information and documents that staff determines are applicable.
"Applicant" means a political subdivision, special district,
				  Indian tribe, or tribal subdivision that applies to the Authority for technical
				  assistance.
"Economic impact summary" means an economic analysis that
				  establishes the economic context for a project based on information provided by
				  the applicant.
"Project" means the whole, or any distinguishable segment or
				  segments, of publicly owned infrastructure for which technical assistance is
				  being requested or provided.
"Project Assistance Account" means an account within the
				  Technical Assistance Program of the Authority designed to provide technical
				  assistance for eligible infrastructure projects that are in the final phases of
				  project development.
"Project Development Account" means an account within the
				  Technical Assistance Program of the Authority designed to provide technical
				  assistance to eligible infrastructure projects that are in the early or
				  exploratory phases of project development.
"Staff" means the Executive Director and other employees of
				  the Department of Commerce.
"Technical assistance round" means a period of time
				  established by the Board during which applications for technical assistance are
				  sent to potential applicants, returned to the Authority, analyzed by Staff, and
				  submitted to the Board for approval or disapproval.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 08 - Greater Arizona Development Authority › Article 1 - TECHNICAL ASSISTANCE › Section R20-8-102 - Application Process

Current through Register Vol. 30, No. 28, July 12, 2024
A. The Board
				shall annually establish a due date by which applications for technical
				assistance from either the Project Development Account or the Project
				Assistance Account, or both accounts, shall be submitted for each technical
				assistance round, and the number of technical assistance rounds to be held in a
				given state fiscal year. To the extent it deems necessary, the Board may extend
				the due date by which applications for technical assistance are to be
				submitted.
B. The Authority shall
				notify potential applicants in writing by electronic or other means of the due
				date for applications at least 60 days before applications are due. Other
				interested persons may submit requests to the Authority to be placed on a
				notification list to be utilized by the Authority.
C. An applicant shall provide to the
				Authority by the established due date for applications on a form provided by
				the Authority the following information:
1.
				Contact information for the applicant, including name, address, and telephone
				number;
2. A description of the
				type of technical assistance being requested and an estimate of the cost of the
				technical assistance;
3. A detailed
				description of the project;
4. A
				summary of the anticipated economic impact the project will have on the
				community as estimated by the applicant;
5. The estimated starting date, completion
				date, and projected cost of the infrastructure project for which the technical
				assistance is being requested;
6.
				The projected sources and uses of funds for the infrastructure project,
				including public and private in-kind contributions;
7. A list of professional and outside service
				providers who have worked with the applicant on any part of the
				project;
8. An indication of
				whether the application is for monies from the Project Development Account or
				the Project Assistance Account; and
9. The amount of the applicant's cash
				contribution to the technical assistance project.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 08 - Greater Arizona Development Authority › Article 1 - TECHNICAL ASSISTANCE › Section R20-8-103 - Eligibility Criteria

Current through Register Vol. 30, No. 28, July 12, 2024
Applicants for the Project Assistance Account must satisfy
				  all of the requirements in A.R.S. §
									41-2256
				  in addition to the items below. To be eligible to receive technical assistance,
				  an applicant shall satisfy all of the following criteria:
1. The applicant is a political subdivision,
				Indian tribe, tribal subdivision, or special district;
2. The technical assistance requested is for
				the development of an infrastructure project;
3. The application is administratively
				complete;
4. The applicant provides
				evidence that the project has public support;
5. The applicant provides evidence that the
				project is part of an adopted comprehensive plan, for example, a capital
				improvement plan, a local strategic plan, general plan, comprehensive plan or
				similar planning document or evidence that the project has been discussed in
				meetings or in study sessions of the governing body of the applicant;
6. The cost of the technical assistance does
				not exceed 10% of the total cost of the final project;
7. The applicant does not have an open award
				for technical assistance from the Authority;
8. The applicant is not requesting technical
				assistance for a project that has already received funds from the Financial
				Assistance Program; and
9.
				Applicants are responsible for the payment of all administrative fees and
				penalties associated with technical assistance. Administrative fees shall be
				paid on or before 90 days from the date on the Authority's invoice.
				Administrative fees remaining unpaid after 90 days from the date of the
				Authority's invoice shall be subject to penalties of five percent per annum.
				Applicants with outstanding administrative fees or penalties are not eligible
				for technical or financial assistance.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 08 - Greater Arizona Development Authority › Article 1 - TECHNICAL ASSISTANCE › Section R20-8-104 - Priority; Approval and Disapproval; Appeal

Current through Register Vol. 30, No. 28, July 12, 2024
A. During each technical assistance round,
				the Board shall determine the order and priority of infrastructure projects,
				for both the Project Development Account and the Project Assistance Account,
				for which an eligible application for technical assistance has been received.
				Application scores shall be prioritized based on a percentage of the points
				received to total points possible.
B. For the Project Development Account, the
				Board shall use a scale of 100 points maximum for all applications based on
				subsection (B)(1) and (2). The minimum number of points required to be eligible
				for consideration for award by the Board shall be 70 percent or 70 points.
				Applicants scoring less than 70 percent will be notified in writing by
				electronic or other means. A score of 70 percent or higher does not guarantee
				funding.
1. Applications for monies from the
				Project Development Account shall be assigned points under the following
				categories in descending order of importance:
a. Population as of the latest decennial
				census - only one of the following:
i. Cities
				or towns having a population up to and including 50,000 or counties having a
				population up to and including 200,000 - 30 points; or
ii. Tribes and special districts - 30 points;
				or
iii. Cities or towns having a
				population of more than 50,000 or counties having a population of more than
				200,000 - 0 points.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 08 - Greater Arizona Development Authority › Article 2 - FINANCIAL ASSISTANCE › Section R20-8-202 - Application Process

Current through Register Vol. 30, No. 28, July 12, 2024
A. The Board
				shall annually establish due dates by which applications for financial
				assistance shall be submitted.
B.
				The Authority shall notify in writing by electronic or other means potential
				applicants of the due date for applications and of any limitation of the amount
				of funding available at least 60 days before applications are due. Other
				interested persons may submit requests to the Authority to be placed on a
				notification list to be utilized by the Authority.
C. An applicant shall provide to the
				Authority by the established due date for applications on a form provided by
				the Authority the following information:
1.
				Contact information for the applicant, including name, address, and telephone
				number;
2. Financial statements,
				audits, or comprehensive annual financial statements relating to the applicant
				for the applicant's current fiscal year;
3. Financial statements, audits, or
				comprehensive annual financial statements relating to the applicant for the
				previous five fiscal years;
4. The
				proposed or estimated financial statement or budget, and business plan or
				management plan for the current and next fiscal years;
5. A fee schedule for the applicable
				enterprise funds for the current and past five fiscal years if not included in
				response to subsections (C)(2), (3), and (4);
6. The source of pledged revenues or
				dedicated revenue source to be used to repay the requested financial
				assistance;
7. The amount of
				pledged revenues or money collected through the dedicated revenue source for
				each of the previous five fiscal years;
8. An estimate of the amount of pledged
				revenues or money that will be collected through the dedicated revenue source
				for the current fiscal year;
9. A
				projection of the amount of pledged revenues or money that will be collected
				through the dedicated revenue source for each of the next five fiscal
				years;
10. A list of professional
				and outside service providers, including their professional qualifications,
				that are working or have worked on the project;
11. An estimate of the project costs,
				including applicable planning, design, and construction costs, as well as
				estimated annual operation, maintenance, and replacement costs;
12. An estimated schedule of required
				disbursements of the financial assistance; and
13. Any information that may have a negative
				effect on the applicant's application, or on its financial condition, including
				material information relating to other projects undertaken by the applicant,
				pending lawsuits, and current investigations by state or federal authorities.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 08 - Greater Arizona Development Authority › Article 2 - FINANCIAL ASSISTANCE › Section R20-8-203 - Eligibility Criteria

Current through Register Vol. 30, No. 28, July 12, 2024
To be eligible to receive financial assistance, an applicant
				  shall satisfy all of the following criteria:
1. The applicant is a political subdivision,
				special district, or Indian tribe;
2. The financial assistance requested is for
				an infrastructure project;
3. The
				application is administratively complete;
4. The applicant demonstrates that the
				financial assistance can be repaid and the level of security pledged to the
				loan is consistent with A.R.S. §§
									41-2257(D)(4)
				through (6);
5. The applicant demonstrates that the
				project is ready for construction and the applicant is ready to
				proceed;
6. The applicant provides
				evidence that the project has public support;
7. The applicant provides evidence that the
				project is part of an adopted comprehensive plan, for example, a capital
				improvement plan, local strategic plan, general plan, comprehensive plan or
				similar planning document;
8. The
				applicant demonstrates that the loan proceeds will be managed and expended in
				accordance with the timetable set forth in the application;
9. The minimum number of points required to
				be eligible for consideration for funding by the Board shall be 70 percent or
				70 points; and
10. Applicants are
				responsible for the payment of all administrative fees and penalties associated
				with financial assistance. Administrative fees shall be paid on or before 90
				days from the date on the Authority's invoice. Administrative fees remaining
				unpaid after 90 days from the date on the Authority's invoice shall be subject
				to penalties of five percent per annum. Applicants with outstanding
				administrative fees or penalties are not eligible for financial or technical
				assistance.
Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 08 - Greater Arizona Development Authority › Article 2 - FINANCIAL ASSISTANCE › Section R20-8-204 - Priority; Approval and Disapproval; Funding; Appeal

Current through Register Vol. 30, No. 28, July 12, 2024
A. The Board shall not review an application
				for financial assistance that does not meet the eligibility criteria in
				R20-8-203.
B. During each financial
				assistance round, the Board shall determine the order and priority of
				infrastructure projects for which an eligible application for financial
				assistance has been received. Application scores shall be prioritized based on
				a percentage of the points received to total points possible. The minimum
				number of points required to be eligible for consideration for funding by the
				Board is 70 percent or 70 points. Applicants scoring less than 70 percent will
				be notified in writing by electronic or other means. A score of 70 percent does
				not guarantee funding. Applications for financial assistance shall be assigned
				points under the following categories in descending order of importance:
1. The applicant demonstrates strong credit
				worthiness and ability to repay the obligation based on the source of the
				repayment pledge - Up to 50 points,
a.
				Category I, A, and general obligation pledges - Up to 50 points; or
b. Category II, Baa, BBB, and previously
				unrated pledges with coverage ratios of 1.50 or higher - Up to 45 points;
				or
c. Previously unrated pledges
				with coverage ratios less than 1.50 - Up to 35 points.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-102 - Scope and Application

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				This Article governs requests for and release of DCS Information made under
				A.R.S. §
									8-807
				and A.R.S. §
									8-807.01.
B. DCS maintains information in accordance
				with federal laws under A.R.S. §
									8-807.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-103 - Procedures for Requesting Dcs Information

Current through Register Vol. 30, No. 28, July 12, 2024
A. A person who wishes to obtain DCS
				Information shall comply with A.R.S. §
									8-807
				and the requirements of this Article.
B. The requester shall submit to the
				Department a completed request or use the form provided by the Department. The
				request shall include the following information:
1. Requester's name, address, and telephone
				number;
2. Name of the child victim
				who is the subject of the DCS report, with as much of the following information
				as the requester can provide on the child victim:
a. Other possible spellings, names, or
				aliases for the child;
b. Date of
				birth;
c. The name of the child's
				caregivers, parents, guardians, and custodians; and
d. The date of the DCS report or time-frame
				for the report.
3. Any
				other data that the requester believes will assist the Department in
				identifying the DCS Information requested, such as:
a. The name of the child's
				siblings;
b. The child's Social
				Security number;
c. The name of the
				DCS Child Safety Worker handling the case; and
d. The location of the alleged abuse or
				neglect.
4. Any
				additional information the Department requests to assist in processing the
				person's request for DCS Information.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-104 - Procedures for Processing a Request for Dcs Information

Current through Register Vol. 30, No. 28, July 12, 2024
A. Upon receipt of a request for DCS
				Information, the Department shall determine whether the request is complete. If
				the request is incomplete, the Department shall either:
1. Return the request to the requester with a
				statement explaining the additional information the Department needs to process
				the request; or
2. Contact the
				requester to obtain the missing information.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-105 - Procedures for Processing a Request for Dcs Information from a Person or Entity Providing Services in Official Capacity

Current through Register Vol. 30, No. 28, July 12, 2024
A. The Department shall release DCS
				Information without charging the fee required by R21-1-110 when a person or
				entity entitled to receive DCS Information requires information to:
1. Meet its duties to provide for the safety,
				permanency, and well-being of a child;
2. Provide services to the child, parent,
				guardian, custodian, or family members to strengthen the family;
3. Enforce or prosecute a violation of child
				abuse or neglect laws;
4. To help
				investigate and prosecute any violation involving domestic violence as defined
				in A.R.S. §
										13-3601,
				or violent sexual assaults as defined in A.R.S. §
										13-1423;
5. Provide DCS Information to a defendant as
				required by an order of the criminal court; or
6. Provide DCS Information to:
a. A juvenile, domestic relations, family or
				conciliation court;
b. The parties
				or their attorneys in a dependency, guardianship, or termination of parental
				rights proceeding;
c. The
				FCRB;
d. A CASA; or
e. A person that provides oversight of
				DCS.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-106 - Release of Summary Dcs Information to a Person Who Reported Suspected Child Abuse and Neglect

Current through Register Vol. 30, No. 28, July 12, 2024
A. A
				person who reports suspected child abuse or neglect to DCS may contact DCS to
				obtain a summary of the outcome of the investigation, as authorized by A.R.S.
				§
									8-807.
B. After receiving a completed request and
				before releasing DCS Information, the Department shall determine that the
				person requesting DCS Information was the person who made the report as
				follows:
1. Obtain the name and telephone
				number of the requester, and
2.
				Compare the requester's name with the name of the person listed as the
				reporting source on the DCS report.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-107 - Release of Dcs Information for a Research or Evaluation Project

Current through Register Vol. 30, No. 28, July 12, 2024
A. A person seeking
				DCS Information for a research or evaluation project shall send a written
				request to the Department. A request shall include the following information:
1. If the person works for a research
				organization:
a. The name of the organization,
				and
b. The organization's
				mission;
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-108 - Release of Dcs Information to a Legislator or a Committee of the Legislature, or Another Person That Provides Oversight

Current through Register Vol. 30, No. 28, July 12, 2024
A. A person that provides oversight of DCS
				and seeks DCS Information shall send a request to the Department and include
				the following information:
1. The name of the
				person seeking the information;
2.
				The purpose of the request and its relationship to the person's official
				duties; and
3. The person's
				signature, or the signature of an authorized agent for an entity or other body,
				confirming that the person or authorized agent understands the DCS Information
				shall not be further disclosed unless authorized by A.R.S. §
										8-807.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-109 - Release of Dcs Information in a Case of Child Abuse, Abandonment, or Neglect That Has Resulted in a Fatality or near Fatality

Current through Register Vol. 30, No. 28, July 12, 2024
A. A person who requests DCS Information
				under A.R.S. §
									8-807.01
				concerning a case of child abuse, abandonment, or neglect that resulted in a
				fatality or near fatality, shall send a written request to the
				Department.
B. Upon receipt of the
				request, the Department shall stamp the receipt date on the request and begin
				gathering the requested DCS Information.
C. Prior to release of DCS Information in a
				case of child abuse or neglect resulting in a fatality or near fatality, the
				Department shall consult with the County Attorney who shall promptly inform the
				Department if it believes the release would cause a specific material harm
				under A.R.S. §
									8-807.01.
				The Department shall not release any information that the County Attorney
				indicates would cause specific material harm.
D. The Department shall notify the requester
				in writing of the estimated copying fee. If the requester does not want to
				proceed, the requester shall notify the Department within 72 hours to cancel
				the request. If this notification is oral, the requester shall confirm the
				cancellation in writing.
E. The
				requester shall pay the estimated copying fee before the Department copies any
				DCS Information.
F. After receipt
				of the final copying fee, the Department shall provide DCS Information
				consistent with A.R.S. §
									8-807
				and A.R.S. §
									8-807.01.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 1 - RELEASE OF DEPARTMENT INFORMATION › Section R21-1-110 - Fees

Current through Register Vol. 30, No. 28, July 12, 2024
A. If the
				Department determines a request for DCS Information will result in a copying
				fee, the Department shall notify the requester of the estimated fee before
				copying any DCS Information.
B.
				Unless otherwise exempted by this Chapter, the Department may charge a copying
				fee at the current rate set by the Department, as provided on the DCS website
				at
https://dcs.az.gov
.
C. The copying fee applies to both paper and
				electronic copies. If the DCS Information is requested in an electronic format,
				but does not already exist in an electronic format, DCS shall apply additional
				fees that reflect the actual cost of conversion to copy the DCS Information to
				an electronic format.
D. The
				Department shall notify the requester in writing of the final copying
				fee.
E. The Department shall
				reimburse the requester if final copying costs are less than the estimated
				copying fee.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-201 - Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
The definitions in A.R.S. §
									8-501 and the
				  following definitions apply to this Article.
1. "AHCCCS" means the Arizona Health Care
				Cost Containment System, which is the State's program for medical assistance
				available under Title XIX of the Social Security Act and state public insurance
				statutes, A.R.S. Title 36, Chapter 29.
2. "Child Safety Worker"
				means the same as A.R.S. §
									8-801.
3. "Covered services"
				means those benefits as described in A.R.S. Title 36, Chapter 29, Article 1 and
				contained in the approved Medicaid State Plan.
4. "DCS CHP Member" means the same as in
				A.R.S. §
									8-512,
				child who is:
a. In a voluntary placement
				under A.R.S. §
										8-806.
b. In the custody of the Department in
				out-of-home placement.
c. In the
				custody of a probation department and placed in foster care. The Department
				shall not provide this care if the cost exceeds funds currently appropriated
				and available for that purpose.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-202 - Eligible Member

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				The Department shall provide DCS CHP to a DCS CHP Member under A.R.S. §
									8-512.
B. The Department shall not provide DCS CHP
				benefits to:
1. An individual who no longer
				meets the eligibility in A.R.S. §
										8-512;
2. A child under the Bureau of Indian Affairs
				foster care program; or
3. A child
				placed in Arizona by another state whether voluntarily or under jurisdiction of
				the court of another state.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-203 - Exceptions, Limitations, and Exclusions

Current through Register Vol. 30, No. 28, July 12, 2024
A. DCS CHP shall not pay for:
1. Non-medically necessary health
				services.
2. Any health service
				that is not eligible for reimbursement by AHCCCS in 9 A.A.C. Chapter 22,
				Article 2, including cosmetic procedures, experimental treatment, and personal
				care items.
3. The cost of care and
				services payable through any federal, state, county, or municipal program to
				which a DCS CHP Member may be entitled, except for the cost of care and
				services in excess of any such program.
4. The cost of care and services payable
				through an insurance carrier that provides coverage for the DCS CHP Member
				under A.R.S. §
										8-512,
				except for the cost of care and services in excess of any such insurance
				benefits.
5. Any admission,
				service, item, or otherwise uncovered service identified in A.R.S. Title 36,
				Chapter 29, Article 1, or the approved Medicaid State Plan.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-204 - Prior Authorization

Current through Register Vol. 30, No. 28, July 12, 2024
A. Healthcare providers may be required to
				obtain authorization from DCS CHP or delegated entity before services are
				rendered in order for those services to be paid for under this Article and
				A.R.S. §
									8-512.
B. DCS CHP shall not pay for any health
				service that requires prior authorization and was:
1. Not submitted for prior authorization;
				or
2. Submitted but prior
				authorization is not granted.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-205 - Coordination of Benefits

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				The Department shall determine the possible existence of any primary insurance
				coverage for a DCS CHP Member.
B.
				The Department shall request that the court include a statement in the court
				order requiring a parent, guardian, or custodian of a DCS CHP Member to
				cooperate with the Department in coordinating benefits with any existing health
				insurance carrier, and to maintain any health insurance coverage presently
				existing which covers a DCS CHP Member.
C. The Department shall advise the court when
				a parent or guardian of a DCS CHP Member refuses to cooperate with DCS CHP in
				providing or signing any document required to coordinate insurance benefits, or
				if the parent, guardian, or custodian fails to maintain any existing insurance
				coverage for the DCS CHP Member.
D.
				In a voluntary placement, the parent or guardian shall cooperate with the
				Department by providing and signing appropriate documents required to
				coordinate health insurance benefits.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-206 - Identification Card

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				The Department shall issue a DCS CHP identification card for each DCS CHP
				Member.
B. The Department shall,
				upon placement, inform the out-of-home care provider in writing that:
1. The identification card is not
				transferable; and
2. The
				out-of-home care provider shall only use the card for covered services for the
				DCS CHP Member.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-207 - Payment and Review of Claims

Current through Register Vol. 30, No. 28, July 12, 2024
A. Healthcare provider shall submit a claim
				for payment in the manner prescribed by the Department
B. DCS CHP shall not pay a claim for a
				service if the DCS CHP Member does not keep an appointment, or if a service was
				not provided.
C. A healthcare
				provider shall provide a covered service to the DCS CHP Member before
				submitting a claim for the covered service to DCS CHP.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-208 - Fraud, Waste, and Abuse of the Program

Current through Register Vol. 30, No. 28, July 12, 2024
A. The Department shall establish a procedure
				to investigate any alleged fraud, waste, and abuse of DCS CHP. If the
				Department substantiates abuse, the Department shall take administrative action
				and may take legal action.
B. The
				Department shall monitor the activity of DCS CHP to ensure compliance with the
				program requirements.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-209 - Administration of the Program

Current through Register Vol. 30, No. 28, July 12, 2024
A. The Department may contract with any
				insurer, insurance plan, hospital service plan, or any health service plan
				authorized to do business in this state, with any fiscal intermediary, or with
				any combination of such plans or methods as permitted in A.R.S. Title 36,
				Chapter 29, Article 1.
B. Any
				contract with any of the entities listed in subsection (A), shall:
1. Be specific as to the responsibilities of
				each party to the contract;
2.
				Provide for reasonable payment to the contractor for its administrative and
				other services as required by the contract; and
3. Be consistent with the rules in this
				Article and authorizing legislation. The parties may make changes to the
				contract by mutual consent signed by an authorized representative of the
				Department and the contractor to be consistent with current rules and
				legislation.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-210 - Program Practices

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				All federal and state laws, regulations, and rules regarding the disclosure and
				use of confidential health and personal information concerning a DCS CHP Member
				shall apply under this Article.
B.
				All federal and state non-discrimination laws, regulations, and rules shall
				apply under this Article.
C. The
				DCS CHP shall take into account the DCS CHP Member's and out-of-home care
				provider's literacy and culture and make interpreters and translation for
				health services available to a DCS CHP Member at no cost.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-211 - Consent for Treatment

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				For a DCS CHP Member in a voluntary placement under A.R.S. §
									8-806
				only, the Department shall obtain consent of the parent or guardian for medical
				treatment involving surgery, general anesthesia, or blood transfusion of the
				DCS CHP Member, except for an emergency situation described in subsection
				(B).
B. In case of an emergency, in
				which the DCS CHP Member in voluntary placement is in need of immediate
				hospitalization, medical attention, or surgery, and when the parents of a DCS
				CHP Member in voluntary placement cannot readily be located, the consent shall
				be provided as described in A.R.S. §
									8-514.05.
C. For a DCS CHP Member under
				R21-1-201(5)(b)
				 who is in the custody of the Department in
				an out-of-home placement, the Department shall, if possible, obtain the consent
				of the parent or guardian of the DCS CHP Member for surgery, general
				anesthesia, or blood transfusion.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-212 - Payment

Current through Register Vol. 30, No. 28, July 12, 2024
DCS CHP may pay a
				  Healthcare provider in accordance with the established AHCCCS fee schedule
				  unless otherwise permitted by A.R.S. §
									8-512,
				  or in the contract between the Department or subcontractor and a
				  provider.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 2 - DCS COMPREHENSIVE HEALTH PLAN › Section R21-1-213 - Provider Claim Disputes and Appeals

Current through Register Vol. 30, No. 28, July 12, 2024
A. Provider
				claim disputes and Member Appeals for a DCS CHP Member who is Medicaid eligible
				follow the rules prescribed in 9 A.A.C. 34.
B. Provider claim disputes and Member Appeals
				for a DCS CHP Member who is not Medicaid eligible follow:
1. A.A.C.
				R9-34-203.
				Computation of Time,
2. A.A.C.
				R9-34-208. Who May
				File,
3. A.A.C.
				R9-34-209.
				Enrollee Time-frame for Filing an Appeal or Grievance with the
				Contractor,
4. A.A.C.
				R9-34-210.
				Contractor General Requirements for Grievance or Appeal Process,
5. A.A.C.
				R9-34-213.
				Contractor Time-frame for Standard Resolution of an Appeal,
6. A.A.C.
				R9-34-214.
				Contractor Process for an Expedited Resolution of an Appeal,
7. A.A.C.
				R9-34-215.
				Contractor Time-frame for an Expedited Appeal Resolution,
8. A.A.C.
				R9-34-225.
				Reversed Appeal Resolutions,
9.
				A.A.C.
				R9-34-403.
				Computation of Time,
10. A.A.C.
				R9-34-404. Content of Claim Dispute, and
11. A.A.C.
				R9-34-405.
				Filing a Claim Dispute for a Claim Involving a Member Enrolled with a
				Contractor.
Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 1 - DEPARTMENT OF CHILD SAFETY - ADMINISTRATION › Article 3 - APPEALS AND HEARING PROCEDURES › Section R21-1-302 - Hearing Proceedings

Current through Register Vol. 30, No. 28, July 12, 2024
Unless otherwise expressly addressed, all pre-hearing and
				  hearing proceedings in A.R.S. §§
									41-1092.01
				  through A.R.S.
				  41-1092.09
				  and 2 A.A.C. 19 shall apply.