Section R9-31-204. Inpatient General Hospital Services

A contractor, fee-for-service provider, or noncontracting provider shall render inpatient general hospital services including:

1.        Hospital accommodations and appropriate staffing, sup- plies, equipment, and services for:

a.         Maternity care, including labor, delivery, recovery room, birthing center, and newborn nursery;

b.        Neonatal intensive care unit (NICU);

c.         Intensive care unit (ICU);

d.        Surgery, including surgery room and recovery room;

e.         Nursery and related services;

f.         Routine care; and

g.        Emergency  behavioral  health   services  under   9

A.A.C. 31, Article 12.

2.        Ancillary services as specified by the Director and included in contract:

a.         Laboratory services;

b.        Radiological and medical imaging services;

c.         Anesthesiology services;

d.        Rehabilitation services;

e.         Pharmaceutical services and prescription drugs;

f.         Respiratory therapy;

g.        Blood and blood derivatives; and

h.        Central supply items, appliances, and equipment not ordinarily furnished to all patients which are cus- tomarily reimbursed as ancillary services.

3.        Providers are not required to obtain prior authorization from the Administration for the following inpatient hos- pital services:

a.         Dialysis shunt placement,

b.        Arteriovenous graft placement for dialysis,

c.         Angioplasties or thrombectomies of dialysis shunts,

d.        Angioplasties or thrombectomies of arteriovenous graft for dialysis,

e.         Hospitalization for vaginal delivery that does not exceed 48 hours,

f.         Hospitalization for  cesarean  section  delivery  that does not exceed 96 hours, and

g.        Other  services  identified  by  the  Administration through the Provider Participation Agreement.

Historical Note

Adopted under an exemption from A.R.S. Title 41, Chap- ter 6, pursuant to Laws 1998, Ch. 4, § 11, 4th Special Ses-

sion, effective October 23, 1998 (Supp. 98-4). Amended by final rulemaking at 8 A.A.R. 2365, effective May 9, 2002 (Supp. 02-2). Amended by final rulemaking at 17

A.A.R. 1681, effective August 2, 2011 (Supp. 11-3).