Ariz. Admin. Code § R9-6-406 - Notification Requirements

A. An enrolled individual or the enrolled individual's representative shall notify the Department in writing or by telephone and comply with the applicable requirements specified in R9-6-407 within 30 calendar days after any of the following occurs:

1. The residential or mailing address or the telephone number of the enrolled individual changes from that provided to the Department under R9-6-404(A)(1) or R9-6-407;

2. The enrolled individual adds or removes an individual with whom the Department may speak about the enrolled individual's ADAP enrollment from the list specified in R9-6-404(A)(1)(h);

3. The enrolled individual begins receiving treatment for HIV infection from a primary care provider different from the primary care provider who completed:

a. The form specified in R9-6-404(B), or

b. The most recent form specified in R9-6-407(D);

4. 3. The enrolled individual has:

a. Lost health insurance coverage;

b. Been determined eligible for and enrolled to receive drug coverage through AHCCCS;

b. c. Been determined eligible for or obtained health insurance coverage, other than through AHCCCS, the Indian Health Service, the Veterans Health Administration, or the health insurance coverage previously used by the enrolled individual; or

c. d. Been determined eligible for a low-income subsidy;

5. 4. The enrolled individual's annual household income has changed

a. Increased to an amount above 300% of the poverty level, or

b. Decreased to an amount that may make the enrolled individual eligible for enrollment in AHCCCS; or

6. 5. The enrolled individual establishes residency outside Arizona.

B. An enrolled individual's primary care provider shall:

1. Notify the Department in writing or by telephone:

a. That the enrolled individual has died, within 14 calendar days after the primary care provider learns of the death; and

b. That the enrolled individual is receiving treatment for HIV infection from a different primary care provider, within 14 calendar days after the primary care provider learns of the change in primary care provider; and

2. Include in the notification:

a. The name and date of birth of the enrolled individual;

b. If notifying under subsection (B)(1)(a), the date of death; and

c. If notifying under subsection (B)(1)(b), the name, business address, and telephone number of the new primary care provider.

C. An enrolled individual's primary care provider shall notify the vendor pharmacy, as specified in R9-6-409(A):

1. When prescribing a new drug for the enrolled individual, or

2. Within seven calendar days after discontinuing a drug that was contained in the list completed by the enrolled individual's primary care provider under R9-6-404(B) or R9-6-407(D).

B. Within 30 calendar days after an enrolled individual loses health insurance coverage, the enrolled individual shall provide to the Department documentation stating the loss of health insurance coverage.

D. C. An enrolled individual's case manager shall notify the Department in writing or by telephone within 30 calendar days after the case manager learns that:

1. The residential or mailing address or the telephone number of the enrolled individual has changed from that provided to the Department under R9-6-404(A)(1) or R9-6-407;

2. The enrolled individual has begun receiving treatment for HIV infection from a primary care provider who is different from the primary care provider who completed:

a. The form specified in R9-6-404(B), or

b. The most recent form specified in R9-6-407(D);

3. 2. The enrolled individual :

a. Has been determined eligible for and enrolled to receive drug coverage through AHCCCS;

b. Obtained health insurance coverage other than AHCCCS, the Indian Health Service, or the Veterans Health Administration; or

c. Has been determined eligible for a low-income subsidy;

4. 3. The enrolled individual's annual household income has changed

a. Increased to an amount above 300% of the poverty level; or

b. Decreased to an amount that may make the enrolled individual eligible for enrollment in AHCCCS;

5. 4. The enrolled individual has established residency outside Arizona; or

6. 5. The enrolled individual has died.

Notes

Ariz. Admin. Code § R9-6-406

Adopted as an emergency effective January 12, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-1). Emergency expired. Readopted without change as an emergency effective May 9, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-2). Amended and readopted as an emergency effective August 8, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-3). Emergency expired. Readopted without change as an emergency effective November 16, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-4). Emergency expired. Adopted without change as a permanent rule effective May 22, 1989 (Supp. 89-2). Amended effective September 19, 1990 (Supp. 90-3). Renumbered from R9-6-806 effective October 19, 1993 (Supp. 93-4). Former Section R9-6-406 renumbered to R9-6-407; new Section R9-6-406 renumbered from R9-6-405 and amended by final rulemaking at 8 A.A.R. 1953, effective April 3, 2002 (Supp. 02-2). Former R9-6-406 renumbered to R9-6-407; new R9-6-406made by final rulemaking at 13 A.A.R. 3329, effective November 10, 2007 (Supp. 07-3). Amended by final rulemaking at 25 A.A.R. 3614, effective 12/3/2019.