Ariz. Admin. Code § R9-1-504 - Sliding Fee Schedule Submission and Contents

A. By April 1 of each year, a provider shall submit to the Department the provider's sliding fee schedule, including:

1. A sliding fee schedule with fee percentages,

2. A sliding fee schedule with flat fees, or

3. A sliding fee schedule with fee percentages and a sliding fee schedule with flat fees.

B. A sliding fee schedule with fee percentages shall contain:

1. A statement that the sliding fee schedule applies to charges for all medical services provided to uninsured individuals by or through the provider;

2. The current federal poverty guidelines;

3. For an uninsured individual with a family income equal to or less than 100 percent of the current federal poverty guidelines, a 100 percent reduction; and

4. For uninsured individuals with family incomes more than 100 percent of the current federal poverty guidelines but not more than 200 percent of the current federal poverty guidelines, at least three fee percentage levels that increase as family income increases.

C. A sliding fee schedule with flat fees shall contain:

1. The requirements listed in subsections (B)(1) and (B)(2);

2. The flat fee for each medical service or group of medical services;

3. For an uninsured individual with a family income equal to or less than 100 percent of the current federal poverty guidelines, a $0 flat fee for each medical service or group of medical services included under subsection (C)(2); and

4. For uninsured individuals with family incomes more than 100 percent of the current federal poverty guidelines but not more than 200 percent of the current federal poverty guidelines, at least three flat fee levels that increase as family income increases for each medical service or group of medical services included under subsection (C)(2).

Notes

Ariz. Admin. Code § R9-1-504

New Section made by final rulemaking at 12 A.A.R. 3990, effective December 4, 2006 (Supp. 06-4).