Section R9-28-306. Reassessments

A.      An assessor shall reassess an ALTCS member to determine continued eligibility:

1.        In connection with a routine audit of the PAS assessment by AHCCCS;

2.        In connection with a request by a provider, program con- tractor, case manager, or other party, if AHCCCS deter- mines that continued eligibility is uncertain due to substantial evidence of a change in the member’s circum- stances or error in the PAS assessment; or

3.        Annually when part of a population group identified by the Director in a written report as having an increased likelihood of becoming ineligible.

B.       An assessor shall determine continued eligibility for ALTCS using the same criteria used for the initial PAS assessment as prescribed in R9-28-303.

C.      An assessor shall refer the reassessment to physician consul- tant review if the member is:

1.        Determined ineligible,

2.        In the ALTCS Transitional Program under R9-28-307 and resides in a NF or ICF-MR, or

3.        Seriously mentally ill and no longer has a non-psychiatric medical condition that impacts the member’s ability to function.

Historical Note

Adopted effective September 1, 1995, under an exemp- tion from A.R.S. Title 41, Chapter 6, pursuant to Laws 1994, Ch. 322, § 21; filed with the Office of the Secretary of State June 29, 1995 (Supp. 95-3). Former Section R9- 28-306 renumbered to R9-28-307; new Section R9-28- 306 renumbered from R9-28-305 and amended by final rulemaking at 7 A.A.R. 5824, effective December 7, 2001 (Supp. 01-4). Amended by final rulemaking at 10 A.A.R.

1312, effective May 1, 2004 (Supp. 04-1).