A. Except as otherwise specifically provided by this article, the system is financially responsible for only the costs of care provided by contractors to members.

Terms Used In Arizona Laws 36-2910

  • 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
  • Director: means the director of the Arizona health care cost containment system administration. See Arizona Laws 36-2901
  • Noncontracting provider: means a person who provides health care to members pursuant to this article but not pursuant to a subcontract with a contractor. See Arizona Laws 36-2901
  • System: means the Arizona health care cost containment system established by this article. See Arizona Laws 36-2901

B. For purposes of eligibility determination and enrollment in the system, the director may adopt rules to establish notification procedures for contractors and noncontracting providers of care provided to persons who may be eligible or who have been determined eligible. The director may condition payment for such services on the compliance of a contractor or noncontracting provider with the notification procedures. The director may adopt rules that establish procedures and notices for the transfer of members between contractors and noncontracting providers as the transfer relates to the system.