R6-6-1510. Amending an HCBS Certificate

A. A service provider shall request an amendment to the HCBS certificate when any of the following information or circumstances change: 1. Name, address, or telephone number; 2. Addition of a service to the Division’s service contract; 3. Deletion of a service to the Division’s service contract; 4. Change in the Tax ID#; or 5. Change in AHCCCS provider type. B. The service provider shall file a request for amendment not more than 30 days after the change by sending a written request to the Division. C. The Division shall mail the service provider written notice of amendment approval or denial within 30 days of receipt of the written request.