Section R9-34-302. Definitions

A.       "Action" by AHCCCS or a tribal contractor means:

1.       The denial or limited authorization of a requested service, including the type or level of service;

2.        The reduction, suspension, or termination of a previously authorized service;

3.        The failure to provide services in a timely manner as set forth in contract; or

4.        The failure of AHCCCS to act within the time-frames specified in this Article.

B.       "AHCCCS" means the AHCCCS Administration as defined in

A.R.S. § 36-2901.

C.       "Appeal" means a request for review of an action.

D.       "Day" means calendar day unless otherwise specified.

E.       "Director" means the Director of the Arizona Health Care Cost Containment System Administration or designee.

F.        "Director's Decision" means the final administrative decision under A.R.S. § 41-1092(5).

G.       "FPS member" means an FPS member eligible for AHCCCS under A.R.S. Title 36, Chapter 29, and who is enrolled with AHCCCS on an FPS basis.

Title 9, Ch. 34                                                                Arizona Administrative Code

Arizona Health Care Cost Containment System - Grievance System

H.       "Filed" means the date that AHCCCS receives a request as established by a date stamp on the request or other record of receipt.

I.         "Institution for Mental Disease" means an institution defined in 42 CFR 435.1009 and licensed by the Arizona Department of Health Services.

J.    "State Fair Hearing" means an administrative hearing under

A.RS. Title 41, Chapter 6, Article 10.

K.       "Working day" means a Monday, Tuesday, Wednesday, Thursday, or Friday unless:

1.       A legal holiday falls on Monday, Tuesday, Wednesday, Thursday, or Friday; or

2.        A legal holiday falls on Saturday or Sunday and a con­ tractor is closed for business the prior Friday or following Monday.

Historical Note

New Section made by final rulemaking at 10 A.A.R. 828, effective April 3, 2004 (Supp. 04-1).