Section R18-12-610. Interim Determinations, Informal Appeals, and Requests for Information

A.      Interim Determinations. Except for incorrect applications or direct payment requests under R18-12-601(C), the Department shall issue a written interim determination on an application or direct payment request in accordance with A.R.S. § 49-1091. The Department shall include in the interim determination information related to filing a notice of disagreement. The 90- day time period under A.R.S. § 49-1091(I) may be suspended in accordance with A.R.S. § 49-1052(B).

B.       Notice of Disagreement. In response to the written interim determination on an application or direct payment request, or the Department’s failure to issue a written determination within 90 days, an owner, operator, or volunteer may submit a notice of disagreement. The notice of disagreement shall:

1.        Be in writing and include the original signature of the owner, operator, or volunteer;

2.        Be submitted within 30 days of receipt of the interim determination by the owner, operator, or volunteer;

3.        Identify and describe the specific portions of the written interim determination with which the owner, operator, or volunteer disagrees; and

4.        If the owner, operator, or volunteer elects, include a request for an informal appeal meeting with the Depart- ment.

C.      Informal Appeal Meeting. If requested, the Department shall schedule an informal appeal meeting regarding a notice of dis- agreement within 30 days of receiving the request. An infor- mal appeal meeting shall be held at the Department at a date and time as mutually agreed among the Department and the owner, operator, or volunteer. The owner, operator, or volun- teer shall attend, by person or telephone, the informal appeal meeting, unless the owner, operator, or volunteer designates, in writing, a person to represent the owner, operator, or volun- teer at the informal appeal meeting. The owner, operator, or volunteer shall notify the Department if the owner, operator, or volunteer intends to bring an attorney to the informal appeal meeting.

D.      Additional Information. The Department may request addi- tional information from an owner, operator, or volunteer who files a notice of disagreement if the information is necessary for the Department to make a final determination on an appli- cation or direct payment request. The requested information shall be submitted within 15 days of the request by the Depart-

	ment or the information may not be considered in the Depart-		written notice to each eligible person or designated representa-
	ment’s final determination. The owner, operator, or volunteer		tive of an owner or operator with an application or direct pay-
	may request an additional 60 days to submit the requested		ment request under review that has not waived financial need
	information, but only if the request for additional time is made		priority points. The general notice shall be issued within 15
	before the day the requested information is originally due to		days of the Director’s establishment of a ranking period under
	the Department. Before the final determination under R18-12-		this subsection. The individual direct written notice shall be
	611, the owner, operator or volunteer may submit additional		issued no less than 45 days before the first ranking period fol-
	information to assist the Department in making a final deter-		lowing the Director’s establishment of a ranking period under
	mination. The period of time allowed the Department to make		this subsection. The direct written notice shall include for each
	a final determination shall, if necessary, be extended to allow		application or direct payment request under review, the fol-
	the Department at least 15 days to review the additional infor-		lowing:
	mation.		1.     Eligible person name;
E.	Payment Warrant. If assurance account monies are available,		2.     Department-assigned number for the application or direct
	the Department shall issue with the interim determination, or		payment request;
	within 15 days of the date of the written interim determination,		3.     Facility name, address, and Department-assigned facility
	a  payment  warrant   of  approved  costs,  less  any  applicable		identification number;
	copayment amount to the eligible person or the designated rep-		4.     Department-assigned LUST and release number;
	resentative to whom the owner or operator has assigned pay-		5.     A statement that assignment of priority ranking points
	ment under R18-12-603(B)(9).		and ranking may be necessary because the Director has
	Historical Note		determined that monies in the assurance account may not
	Adopted effective September 21, 1992 (Supp. 92-3). Sec-		be immediately available to pay approved amounts on the
	tion repealed; New Section made by final rulemaking at		reimbursement application or direct payment request;
	12 A.A.R. 1611, effective June 4, 2006 (Supp. 06-2).		6.     For those eligible person’s that have requested a financial
			need  evaluation  on   the  application  or  direct  payment
R18-12-611.   Final Determinations and Formal Appeals			request under review, a statement that to receive financial
A.	Final Determinations. The Department shall issue a written		need priority ranking points the eligible person shall sub-
	final determination to an eligible person regarding an applica-		mit the information required under R18-12-614 no less
	tion or direct payment request as required under A.R.S. §		than 15 days before the ranking period; and
	49-1091(E) or under R18-12-601(C). The Department shall		7.     Estimated date for the first ranking period under subsec-
	ensure  that  this  written   final  determination  complies  with		tion (B).
	A.R.S. Title 41, Chapter 6, Article 10.	B.	Ranking Periods. If the Director determines under subsection
B.	Notice of Appeal or Request for Hearing. An eligible person		(A) that it is necessary for the Department to rank applications
	may appeal a written final determination. To appeal the written		or direct payment requests, the Department shall establish a
	final determination, the eligible person shall submit a notice of		ranking period during which the Department assigns priority
	appeal or request for hearing with an original signature, in		ranking points and makes payments in accordance with sub-
	accordance with A.R.S. § 41-1092.03 and A.A.C. R2-19-108.		sections (C), (D), and (E). The ranking period shall begin on
	The Department shall forward to the Office of Administrative		the date the Director determines assurance account monies
	Hearings notices of appeal and requests for hearing submitted		will be insufficient to pay, upon approval, all approved costs
	in  accordance  with A.R.S.  § 41-1092.03.  The  Department		on reimbursement applications and direct payment requests in
	shall forward to the Office of Administrative Hearings any		process and terminates when the Department is able to pay,
	notice of appeal or request for hearing submitted by the eligi-		upon approval, all approved costs on reimbursement applica-
	ble person or an Arizona-licensed attorney representing the		tions and direct payment requests in process. The Department
	eligible person.		shall hold a ranking period when accumulated available mon-
C.	Interim Determination Becomes Final. In the absence of a		ies in the assurance account, or a portion of the assurance
	written final determination issued in accordance with subsec-		account, are not sufficient to pay all approved amounts for
	tion (A), the written interim determination becomes the final		applications and direct payment requests that are in process.
	determination, as provided in A.R.S. § 49-1091(E). A notice		The assignment of priority ranking points and the ranking pro-
	of appeal or request for hearing relating to a written interim		cess shall be in accordance with the requirements of subsec-
	determination that becomes final under this Section shall be		tions (C) through (F).
	submitted in accordance with subsection (B). The notice of	C.	Scoring. During a ranking period, the Department shall assign
	appeal or request for hearing is timely submitted if it is submit-		priority ranking points to score affected applications and direct
	ted within 30 days of the date on which the written final deter-		payment requests as follows:
	mination was due in accordance with subsection (A).		1.     The Department shall assign the sum of the following

Historical Note

New Section made by final rulemaking at 12 A.A.R.

1611, effective June 4, 2006 (Supp. 06-2).