If the director determines through the grievance and appeal procedure pursuant to a grievance or appeal filed by an applicant that the administration made an error in eligibility determination pursuant to section 36-2933 and a person was incorrectly determined to be ineligible to receive institutional or home and community based services, the administration shall reimburse a provider or noncontracting provider for unreimbursed services provided to the applicant. The administration shall only make reimbursements for services pursuant to this article and from the date the person was incorrectly determined to be ineligible so long as the person remains eligible or until the person is enrolled in the system, whichever is applicable.

Terms Used In Arizona Laws 36-2954

  • Administration: means the Arizona health care cost containment system administration. See Arizona Laws 36-2931
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Director: means the director of the Arizona health care cost containment system administration. See Arizona Laws 36-2931
  • Home and community based services: means services described in section 36-2939, subsection B, paragraph 2 and subsection C. See Arizona Laws 36-2931
  • Noncontracting provider: means a person who provides services as prescribed by section 36-2939 and who does not have a subcontract with a program contractor. See Arizona Laws 36-2931
  • Person: includes a corporation, company, partnership, firm, association or society, as well as a natural person. See Arizona Laws 1-215
  • Provider: means a person who subcontracts with a program contractor for the delivery of services to members pursuant to this article. See Arizona Laws 36-2931
  • System: means the Arizona long-term care system. See Arizona Laws 36-2931
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