Section R9-28-413. Enrollment with an Elderly and Physically Dis- abled (EPD) Program Contractor

A.      A member's enrollment with an EPD program contractor. The Administration shall enroll an ALTCS elderly or physically disabled member with an EPD program contractor assigned to that GSA.

B.       New member makes a choice of an EPD program contractor. The Administration shall provide a new member an opportu- nity to choose an EPD program contractor, if an ALTCS mem- ber is elderly or physically disabled, and lives in a GSA served by more than one EPD program contractor.

C.      New member who makes no choice of an EPD program con- tractor. The Administration shall enroll an elderly or physi- cally disabled new member that lives in a GSA with more than one EPD program contractor and who makes no choice of an EPD program contractor under the following:

1.        Criteria. The Administration will prioritize enrollment based on continuity of care and enroll a member with an EPD program contractor chosen under the following cri- teria, including but not limited to:

a.         A member's living arrangement, and

b.        A member's primary care practitioner.

2.        Algorithm. The Administration shall enroll a member through an algorithm as specified in contract, when a member has a choice of more than one EPD program con- tractor and the criteria in subsection (C)(1) does not apply.

Historical Note

New Section adopted by final rulemaking at 6 A.A.R. 896, effective February 8, 2000 (Supp. 00-1). Amended by final rulemaking at 20 A.A.R. 234, effective January 7, 2014 (Supp. 14-1).