Ariz. Admin. Code § R6-6-1510 - Amending an Hcbs Certificate
A. A
service provider shall request an amendment to the HCBS certificate when any of
the following information or circumstances change:
1. Name, address, or telephone
number;
2. Addition of a service to
the Division's service contract;
3.
Deletion of a service to the Division's service contract;
4. Change in the Tax ID#; or
5. Change in AHCCCS provider type.
B. The service provider shall file
a request for amendment not more than 30 days after the change by sending a
written request to the Division.
C.
The Division shall mail the service provider written notice of amendment
approval or denial within 30 days of receipt of the written request.
Notes
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