Ariz. Admin. Code § R20-6-1916 - Availability Ratios
A. An
HCSO shall maintain a ratio of contracted adult PCPs to adults that is adequate
to provide those adults with covered services. An HCSO with a Medicare
Advantage (MA) plan may have one ratio that applies to both its insured and MA
populations, or a separate ratio for each.
B. An HCSO shall maintain a ratio of
contracted pediatric PCPs to children that is adequate to provide those
children enrollees with covered services.
C. An HCSO shall maintain a ratio of
contracted high profile SCPs to enrollees that is adequate to provide those
enrollees with covered services that include services at contracted facilities.
An HCSO with a MA plan may have one ratio that applies to both its insured and
MA populations, or a separate ratio for each.
Notes
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