41-2807. Medical services; rate structure

If a youth in a secure care facility requires health care services that the department, the facility or a provider contracted by the department cannot provide, the department shall pay approved claims from a facility or provider that provides these services as follows:

1. For inpatient and outpatient hospital services, the department shall reimburse at a level that does not exceed the reimbursement methodology established pursuant to section 36-2903.01, subsection H, unless the department has a contract with the vendor.

2. For health and medical services, the department shall reimburse at a level that does not exceed the capped fee-for-service schedule that is adopted by the Arizona health care cost containment system administration pursuant to title 36, chapter 29, article 1 and that is in effect at the time the services are delivered.

41-2807. Medical services; rate structure

If a youth in a secure care facility requires health care services that the department, the facility or a provider contracted by the department cannot provide, the department shall pay approved claims from a facility or provider that provides these services as follows:

1. For inpatient and outpatient hospital services, the department shall reimburse at a level that does not exceed the reimbursement methodology established pursuant to section 36-2903.01, subsection H, unless the department has a contract with the vendor.

2. For health and medical services, the department shall reimburse at a level that does not exceed the capped fee-for-service schedule that is adopted by the Arizona health care cost containment system administration pursuant to title 36, chapter 29, article 1 and that is in effect at the time the services are delivered.