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.