AHCCCS must verify the license of a provider. When the license is reviewed, it must be from the State of the practice, current and not limited. Enrolled providers must report any adverse action regarding a license, permit, or certification to AHCCCS within 24 hours.
A provider application may only list practice locations that are included on the license. When a license lists only one address, then only one address may be approved per enrollment application. When a license lists more than one address, such as a satellite location, the multiple locations may be considered on the same provider application and enrollment.
See PEPM112A Providers on Tribal Lands for special conditions that apply to provider organizations located on tribal lands.
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Term |
Definition |
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License |
“License” or “licensure” means a nontransferable authorization that is granted based on established standards in law by a state or a county regulatory agency or board and allows a health care provider to lawfully render a health care service. |
License is provided by the provider with their application.
Outpatient treatment centers who are exempt from the license requirement because they are owned by the same owners as a hospital need to provide proof of the license exemption from Arizona Department of Health Services.
Refer to the Provider Enrollment Screening Glossary for the license required for each provider type.
42 CFR 455.412
ARS 36-402
AAC R9-22-101