Ariz. Admin. Code § R20-6-1913 - Demographic Information Reports

A. An HCSO shall report the following data to the Department:

1. For each enrollee, report annually:

a. Street address,

b. Zip code,

c. Gender, and

d. Year of birth.

2. For all contracted providers, report semiannually:

a. Provider name,

b. Street address or addresses at which the provider provides covered services,

c. Zip code, and

d. Arizona license number,

3. For all contracted physicians or practitioners, report semiannually:

a. Specialty, and

b. Medical or other applicable degree or information that designates the type of physician or practitioner.

B. The HCSO shall report the information in subsection (A) to the Department by the following deadlines:

1. For information in subsection (A)(1) as of December 31 of each calendar year, by February 15 of the next calendar year.

2. For information in subsection (A)(2) as of June 30, by August 15 of the same calendar year.

3. For information in subsection (A)(2) as of December 31, by February 15 of the next calendar year.

Notes

Ariz. Admin. Code § R20-6-1913

New Section made by final rulemaking at 11 A.A.R. 4861, effective December 31, 2005 (Supp. 05-4).