A. A
member's enrollment with an EPD program contractor. The Administration shall
enroll an ALTCS elderly or physically disabled member with an EPD program
contractor assigned to that GSA.
B.
New member makes a choice of an EPD program contractor. The Administration
shall provide a new member an opportunity to choose an EPD program contractor,
if an ALTCS member is elderly or physically disabled, and lives in a GSA served
by more than one EPD program contractor.
C. New member who makes no choice of an EPD
program contractor . The Administration shall enroll an elderly or physically
disabled new member that lives in a GSA with more than one EPD program
contractor and who makes no choice of an EPD program contractor under the
following:
1. Criteria. The Administration
will prioritize enrollment based on continuity of care and enroll a member with
an EPD program contractor chosen under the following criteria, including but
not limited to:
a. A member's living
arrangement, and
b. A member's
primary care practitioner.
2. Algorithm. The Administration shall enroll
a member through an algorithm as specified in contract, when a member has a
choice of more than one EPD program contractor and the criteria in subsection
(C)(1) does not apply.
D.
A member enrolled with an EPD program contractor
prior to October 1, 2000, and is enrolled in the system after October 1,
2000.
1.
Choice. The Administration shall request an existing
member residing in a GSA with more than one EPD program contractor to choose an
EPD program contractor.
2.
A member makes no choice. If a member makes no
choice, the Administration will continue enrollment with a member's existing
EPD program contractor. If that existing EPD program contractor is not awarded
a bid, the member will be enrolled with an EPD program contractor as specified
in Section (C).
Notes
Ariz. Admin. Code §
R9-28-413
New Section adopted by
final rulemaking at 6 A.A.R. 896, effective February 8, 2000 (Supp. 00-1).
Amended by final rulemaking at 20 A.A.R. 234, effective January 7, 2014 (Supp.
14-1).
