Ariz. Admin. Code § 9-34-211

Current through Register Vol. 30, No. 50, December 13, 2024

Section R9-34-211 - Contractor Special Requirements for the Appeal Process

A. A contractor shall treat an oral inquiry seeking to appeal an action as an appeal.

B. A resolution of an appeal by the contractor before a State Fair Hearing is an informal resolution under A.R.S. § 36-2903.01(B)(4).

C. The contractor shall provide a reasonable opportunity for an enrollee to present evidence, and allegations of fact or law, in person and in writing. The contractor shall inform the enrollee of the limited time available for this in the case of an expedited resolution.

D. The contractor shall provide the enrollee and representative the opportunity, before and during the appeal process, to examine the enrollee's case file, including medical records, documents, and records considered during the appeal process, not protected from disclosure by law.

E. The contractor shall include, as a party to the appeal, the enrollee or the legal representative of a deceased enrollee's estate.

Ariz. Admin. Code § R9-34-211

New Section made by final rulemaking at 10 A.A.R. 828, effective April 3, 2004 (Supp. 04-1).