R9-28-306. Reassessments

A. An assessor shall reassess an ALTCS member to determine continued eligibility: 1. In connection with a routine audit of the PAS assessment by AHCCCS; 2. In connection with a request by a provider, program contractor, case manager, or other party, if AHCCCS determines that continued eligibility is uncertain due to substantial evidence of a change in the member’s circumstances or error in the PAS assessment; or 3. Annually when part of a population group identified by the Director in a written report as having an increased likelihood of becoming ineligible. B. An assessor shall determine continued eligibility for ALTCS using the same criteria used for the initial PAS assessment as prescribed in R9-28-303. C. An assessor shall refer the reassessment to physician consultant review if the member is: 1. Determined ineligible, 2. In the ALTCS Transitional Program under R9-28-307 and resides in a NF or ICF-IID, or 3. Seriously mentally ill and no longer has a non-psychiatric medical condition that impacts the member’s ability to function.