Ariz. Admin. Code § R20-6-1920 - Travel Requirements
A. An
HCSO may require an enrollee to travel a greater distance in-area to obtain
covered services from a contracted provider than the enrollee would have to
travel to obtain equivalent services from a non-contracted provider, except
where a network exception is medically necessary. Nothing in this Section
creates an exception to
R20-6-1918 through
R20-6-1920.
B. If the HCSO prior-authorizes services that
require an enrollee to travel outside the HCSO service area because the
services are not available in the area, the HCSO shall reimburse the enrollee
for travel expenses. Except as provided under
R20-6-1904(E)(6), an HCSO is not required to reimburse an enrollee for travel expenses the
enrollee incurs to obtain covered services in-area.
Notes
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