36-2931. Definitions

435 words·~2 min read·/az/title-36/36-2931

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

In this article, unless the context otherwise requires:

1. "Administration" means the Arizona health care cost containment system administration.

2. "Capitation rate" means a mode of payment which the program contractor receives for the delivery of services to members pursuant to this article and which is based on a fixed rate per person notwithstanding the amount of services provided to a member.

3. "Department" means the department of economic security.

4. "Director" means the director of the Arizona health care cost containment system administration.

5. "Eligible person" means a person who:

(a)Is a resident of this state and a United States citizen or a person who meets the requirements for qualified alien status as determined pursuant to section 36-2903.03, who entered the United States on or before August 21, 1996 or who entered the United States on or after August 22, 1996 and who is a member of an exception group under Public Law 104-193, section 412.

(b)Meets the eligibility criteria pursuant to section 36-2934.

(c)Needs institutional services as determined pursuant to section 36-2936.

(d)Is defined as eligible pursuant to section 1902(a)(10)(A)(ii)(XV) and

(XVI)of title XIX of the social security act and who meets the income requirements of section 36-2950.

6. "Home and community based services" means services described in section 36-2939, subsection B, paragraph 2 and subsection C.

7. "Institutional services" means services described in section 36-2939, subsection A, paragraph 1 and subsection B, paragraph 1.

8. "Member" means an eligible person who is enrolled in the system.

9. "Noncontracting provider" means a person who provides services as prescribed by section 36-2939 and who does not have a subcontract with a program contractor.

10. "Program contractor" means the department or any other entity that contracts with the administration pursuant to section 36-2940 or 36-2944 to provide services to members pursuant to this article.

11. "Provider" means a person who subcontracts with a program contractor for the delivery of services to members pursuant to this article.

12. "Special health care district" means a special health care district organized pursuant to title 48, chapter 31.

13. "State plan" means a written agreement between the centers for medicare and medicaid services and the Arizona health care cost containment system administration that describes eligibility, covered services and the requirements for participation in the medicaid program except those requirements that are waived pursuant to the research and demonstration waiver pursuant to section 1115 of the social security act.

14. "System" means the Arizona long-term care system.

15. "Uniform accounting system" means a standard method of collecting, recording and safeguarding Arizona long-term care system data.