A. If the administration contracts with behavioral health contractors that would act as regional behavioral health authorities or directly with a service provider for behavioral health services, the administration and each behavioral health contractor or service provider shall prepare and make available monthly summary statements, in a format prescribed by the administration, that separately detail by title XIX and nontitle XIX and by service category and service type, as defined by contract with the administration, the number of clients served, the units of service provided and the state and federal monies distributed through the administration to each regional behavioral health authority or direct contract service provider and the amounts distributed by each regional behavioral health authority or direct contract service provider to its subcontractors. The director may require additional information in the monthly statement that the director determines to be critical for proper regulation and oversight of the regional behavioral health authority or the direct contract service provider.

Terms Used In Arizona Laws 36-3410

  • Administration: means the Arizona health care cost containment system administration. See Arizona Laws 36-3401
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Children: means persons who are under the age of nineteen years or persons who are under the age of twenty-two years and enrolled in an educational facility. See Arizona Laws 36-3401
  • Contract: A legal written agreement that becomes binding when signed.
  • Director: means the director of the administration. See Arizona Laws 36-3401
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Regional behavioral health authority: means an organization under contract with the administration to coordinate the delivery of mental health services in a geographically specific service area of the state for eligible persons. See Arizona Laws 36-3401
  • Service provider: means an organization or mental health professional that meets the criteria established by the administration and has a contract with the administration or a regional behavioral health authority. See Arizona Laws 36-3401

B. For services provided directly by a regional behavioral health authority, the maximum reimbursement to that regional behavioral health authority shall be thirty percent above the Arizona health care cost containment system fee for service rate for the particular service rendered.

C. Except as provided in subsections D and E of this section, behavioral health contractors under contract with the administration to act as regional behavioral health authorities may perform only managed care functions. Regional behavioral health authorities and their subsidiaries shall not deliver behavioral health services directly to clients.

D. If a direct services behavioral health provider experiences contract performance failure, the regional behavioral health authority, after receiving approval from the administration, may provide direct care services for only as long as necessary to ensure delivery of uninterrupted care to clients and either:

1. Accomplish the orderly transition of those members to a new provider or other existing providers.

2. Until the provider in question reorganizes or otherwise corrects the contract performance failure.

E. Subsection C of this section does not apply to a regional behavioral health authority operated by a federally recognized Indian tribe.

F. In the contracts specified under subsection A of this section, the administration may include a provision to charge, payable to the department of health services, for services provided at the state hospital. The charges are only for clients on whose behalf the contractor has been paid by the administration.

G. The summaries and the contracts on which they are based are open to public inspection. The administration and each regional behavioral health authority or direct contract service provider shall make the summaries available for inspection and copying at the office of each regional behavioral health authority or direct contract service provider and at the administration.

H. The administration and a regional behavioral health authority or direct contract service provider shall charge a copying fee that is not in excess of the actual cost of reproduction or the amount charged by the secretary of state pursuant to section 41-126, whichever is less.

I. Copying fees received by the administration, pursuant to subsection H of this section, shall be placed in the Arizona health care cost containment system fund established by section 36-2913.

J. Monies appropriated each fiscal year for children‘s behavioral health services shall be spent on services only as prescribed by the appropriation and may not be used for any other purpose.

K. Monies appropriated each fiscal year for seriously mentally ill services shall be spent on services only as prescribed by the appropriation and shall not be used for any other purpose.

 

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