Section R9-34-322. Reversed Appeal Resolutions

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A. Ifthe Director's Decision reverses a decision to deny, limit, or delay services that were not furnished while the appeal was pending, AHCCCS shall authorize or provide the disputed ser vices promptly, and as expeditiously as the FPS member's health condition requires.

B. Ifthe Director's Decision reverses a decision to deny authori zation of services, and the FPS member received the disputed services while the appeal was pending, AHCCCS shall pay the provider for those services.

Historical Note

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

                    
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