A. A contractor shall intervene if a member inappropriately seeks care at a hospital emergency department four times or more in a six-month period to educate the member regarding the proper use of emergency services.

Terms Used In Arizona Laws 36-2903.11

  • Administration: means the Arizona health care cost containment system administration. See Arizona Laws 36-2901
  • Contractor: means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers. See Arizona Laws 36-2901
  • Department: means the department of economic security. See Arizona Laws 36-2901
  • Member: means an eligible person who enrolls in the system. See Arizona Laws 36-2901

B. A contractor shall report to the administration in a manner prescribed by the administration the number of times the contractor intervenes with members pursuant to this section.

C. On or before December 1, 2017 and on or before December 1 of each year thereafter, the administration shall report to the directors of the joint legislative budget committee and the governor’s office of strategic planning and budgeting on the use of emergency departments for nonemergency purposes by members.

 

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