A.R.S. § 36-2979.04: Covered services

(Conditionally Rpld.)

A. Subject to the approval of the centers for medicare and medicaid services, available appropriations and the enrollment cap prescribed in section 36-2979.01, subsection F, each contractor shall provide enrolled members with the following services:

1. All services that the contractor is required to provide to seriously mentally ill individuals under the contractor's agreement with the administration pursuant to sections 36-3407 and 36-3410, including behavioral health services, physical health services, crisis services, case management and peer support services.

2. Enhanced residential treatment services.

B. The contractor shall conduct, at minimum, an annual review of the ongoing medical necessity of services for each member and shall engage with the member to plan for transition to a less restrictive setting when clinically appropriate.

C. The administration may add, modify or combine services consistent with federal approval and legislative intent, subject to the approval of monies.