State Law

Arizona Admin. Code-Title 20-Chapter 6-Article 19. Health Care Services Organizations Oversight

06/15/2020 Arizona Section R20-6-1914

Access

Network Adequacy

An HCSO shall provide to or arrange for its enrollees services or appointments for services as follows:

1. For preventive care services from a contracted PCP, an appointment date within 60 days of the enrollee’s request, or sooner if necessary, for the enrollee to be immunized on schedule.

2. For routine-care services from a contracted PCP, an appointment date within 15 days of the enrollee’s request to the PCP or sooner if medically necessary.

3. For specialty care services from a contracted SCP, an appointment date within 60 days of the enrollee’s request or sooner if medically necessary.

4. In-area urgent care services from a contracted provider seven days per week.

5. Timely non-emergency inpatient care services from a contracted facility.

6. Timely services from a contracted physician or practitioner in a contracted facility including inpatient emergency care.

7. Services from a contracted ancillary provider during normal business hours, or sooner if medically necessary.

SeeĀ https://apps.azsos.gov/public_services/Title_20/20-06.pdf