Section R9-6-406. Notification Requirements

A.      An enrolled individual or the enrolled individual’s representa- tive shall notify the Department in writing or by telephone and comply with the applicable requirements specified in R9-6- 407 within 30 calendar days after any of the following occurs:

1.        The residential or mailing address or the telephone num- ber of the enrolled individual changes from that provided to the Department under R9-6-404(A)(1) or R9-6-407;

2.        The enrolled individual adds or deletes an individual with whom the Department may speak about the enrolled indi- vidual’s ADAP enrollment from the list specified in R9- 6-404(A)(1)(g);

3.        The enrolled individual begins receiving treatment for HIV infection from a primary care provider  different from the primary care provider who completed:

a.        The form specified in R9-6-404(B), or

b.        The most recent form specified in R9-6-407(D);

4.        The enrolled individual has:

a.        Been determined eligible for and enrolled to receive drug coverage through AHCCCS;

b.        Received notification of drug coverage from a third- party payor other than AHCCCS, the Indian Health Service, or the Veterans Health Administration; or

c.        Been determined eligible for a low-income subsidy;

5.        The enrolled individual’s annual family income has:

a.        Increased to an amount above 300% of the poverty level, or

b.        Decreased to an amount that may make the enrolled individual eligible for enrollment in AHCCCS; or

6.        The enrolled individual establishes residency outside Ari- zona.

B.       An enrolled individual’s primary care provider shall:

1.        Notify the Department in writing or by telephone:

a.        That the enrolled individual has died, within 14 cal- endar days after the primary care provider learns of the death; and

b.        That the enrolled individual is receiving treatment for HIV infection from a different primary care pro- vider, within 14 calendar days after the primary care provider learns of the change in primary care pro- vider; and

2.        Include in the notification:

a.        The name and date of birth of the enrolled individ- ual;

b.        If notifying under subsection (B)(1)(a), the date of death; and

c.        If notifying under subsection (B)(1)(b), the name, business address, and telephone number of the new primary care provider.

C.      An enrolled individual’s primary care provider shall notify the vendor pharmacy, as specified in R9-6-409(A):

1.        When prescribing a new drug for the enrolled individual, or

2.        Within seven calendar days after discontinuing a drug that was contained in the list completed by the enrolled individual’s primary care provider under R9-6-404(B) or R9-6-407(D).

D.      An enrolled individual’s case manager shall notify the Depart- ment in writing or by telephone within 30 calendar days after the case manager learns that:

1.        The residential or mailing address or the telephone num- ber of the enrolled individual has changed from that pro- vided to the Department under R9-6-404(A)(1) or R9-6- 407;

2.        The enrolled individual has begun receiving treatment for HIV infection from a primary care provider who is differ- ent from the primary care provider who completed:

a.        The form specified in R9-6-404(B), or

b.        The most recent form specified in R9-6-407(D);

3.        The enrolled individual has:

a.        Been determined eligible for and enrolled to receive drug coverage through AHCCCS;

b.        Received notification of drug coverage from a third- party payor other than AHCCCS, the Indian Health Service, or the Veterans Health Administration; or

c.        Been determined eligible for a low-income subsidy;

4.        The enrolled individual’s annual family income has:

a.        Increased to an amount above 300% of the poverty level; or

b.        Decreased to an amount that may make the enrolled individual eligible for enrollment in AHCCCS;

5.        The enrolled individual has established residency outside Arizona; or

6.        The enrolled individual has died.

Historical Note

Adopted as an emergency effective January 12, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-1). Emergency expired. Readopted without change as an emergency effective May 9, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-2).

Amended and readopted as an emergency effective August 8, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-3). Emergency expired.

Readopted without change as an emergency effective November 16, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-4). Emergency expired.

Adopted without change as a permanent rule effective May 22, 1989 (Supp. 89-2). Amended effective Septem-

ber 19, 1990 (Supp. 90-3). Renumbered from R9-6-806

effective October 19, 1993 (Supp. 93-4). Former Section R9-6-406 renumbered to R9-6-407; new Section R9-6- 406 renumbered from R9-6-405 and amended by final

rulemaking at 8 A.A.R. 1953, effective April 3, 2002 (Supp. 02-2). Former R9-6-406 renumbered to R9-6-407; new R9-6-406 made by final rulemaking at 13 A.A.R.

3329, effective November 10, 2007 (Supp. 07-3).