R9-31-116. “IHS”

R9-31-116 “IHS” or “Tribal Facility Provider” R9-31-116 “Information” R9-31-103 “Institution for Mental Diseases” or “IMD” 42 CFR 435.1010 and R9-22-102 “Inmate of a public institution” 42 CFR 435.1010 “Inpatient hospital services” R9-31-101 “License” or “licensure” R9-22-101 “Medical record” R9-22-101 “Medical review” R9-31-107 “Medical services” R9-22-101 “Medical supplies” R9-22-102 “Member” A.R.S. § 36-2981 “Mental disorder” A.R.S. § 36-501 “Native American” R9-31-101 “New hospital” R9-22-701 “NF” or “nursing facility” 42 U.S.C. § 1396r(a) “NICU” R9-22-701 “Noncontracting provider” A.R.S. § 36-2981 “Occupational therapy” R9-22-102 “Offeror” R9-31-106 “Operating costs” R9-22-701 “Outlier” R9-31-107 “Outpatient hospital service” R9-22-701 “Ownership change” R9-22-701 “Partial care” R9-22-1201 “Peer group” R9-22-701 “Pharmaceutical service” R9-22-102 “Physical therapy” R9-22-102 “Physician” A.R.S. § 36-2981 “Post stabilization care services” 42 CFR 438.114 “Practitioner” R9-22-102 “Prepaid capitated” A.R.S. § 36-2981 “Prescription” R9-22-102 “Primary care physician” A.R.S. § 36-2981 “Primary care practitioner” A.R.S. § 36-2981 “Primary care provider (PCP)” R9-22-102 “Primary care provider services” R9-22-102 “Prior authorization” R9-22-102 “Program” A.R.S. § 36-2981 “Proposal” R9-31-106 “Prospective rates” R9-22-701 “Provider” A.R.S. § 36-2931 “Psychiatrist” A.R.S. § 36-501 “Psychologist” A.R.S. § 36-501 “Psychosocial rehabilitation” R9-22-102 “Qualified alien” A.R.S. § 36-2903.03 “Qualifying plan” A.R.S. § 36-2981 “Quality management” R9-22-501 “Radiology” R9-22-102 “Rebase” R9-22-701 “Redetermination” R9-31-103 “Referral” R9-22-101 “Regional Behavioral Health Authority” or “RBHA” A.R.S. § 36-3401 “Rehabilitation services” R9-22-102 “Reinsurance” R9-22-701 “Remittance advice” R9-22-701 “RFP” R9-31-106 “Respiratory therapy” R9-22-102 “Scope of services” R9-22-102 “Seriously ill” R9-31-101 “Service location” R9-22-101 “Service site” R9-22-101 “SMI” or “Seriously mentally ill” A.R.S. § 36-550 “Specialist” R9-22-102 “Speech therapy” R9-22-102 “Spouse” R9-31-103 “SSI-MAO” R9-31-103 “Stabilize” 42 U.S.C. § 1395dd “Standard of care” R9-22-101 “Sterilization” R9-22-102 “Subcontract” R9-22-101 “Subcontractor” R9-31-101 “Third-party” R9-22-1001 “Third-party liability” R9-22-1001 “Tier” R9-22-701 “Tiered per diem” R9-31-107 “TRBHA” or “Tribal Regional Behavioral Health Authority” R9-31-1201 “Tribal facility” A.R.S. § 36-2981 “Utilization management” R9-22-501 B. General definitions. The words and phrases in this Chapter have the following meanings unless the context explicitly requires another meaning: “ADHS” has the same meaning as in A.A.C. R9-22-102. “AHCCCS” means the Arizona Health Care Cost Containment System, which is composed of the Administration, contractors, and other arrangements through which health care services are provided to a member. “Applicant” means a person who submits, or whose representative submits, a written, signed, and dated application for Title XXI medical coverage. “Application” means an official request for Title XXI medical coverage made under this Chapter. “Contract year” means the period beginning on October 1 and continuing until September 30 of the following year. “Inpatient hospital services” means medically necessary services that require an inpatient stay in an acute care hospital and that are provided by or under the direction of a physician or other health care practitioner upon referral from a member’s primary care provider. “Native American” means Indian as specified in 42 CFR 137.10. “Seriously ill” means a medical or psychiatric condition manifesting itself by acute symptoms that left untreated may result in: Death, Disability, Disfigurement, or Dysfunction. “Subcontractor” means a person, agency, or organization that enters into an agreement with a contractor or subcontractor to provide services.