Acute Care Health Plan Administrative Actions

Administrative Actions are documents to record regulatory actions by AHCCCS and responses from contracted Health Plans. The absence of information implies that the Contractor is operating within contractual standards.

Types of actions include:

Corrective Action Plan (CAP)

A Corrective Action Plan (CAP) is a Contractor developed measure to improve performance in a particular area of contractual responsibility. Any CAP must identify the following:

  • The root cause(s) of the deficiency
  • The actions/tasks that the Contractor will take to facilitate an expedient return to compliance
  • The timeframe to finish the CAP

Notice to Cure (NTC)

A Notice to Cure (NTC) is a formal written notice to a Contractor regarding specific non-compliance. The NTC contains specific timelines for meeting performance standards and possible penalties for continued non-compliance. An NTC may contain specific activities or reporting requirements that must be adhered to as the Contractor works toward compliance. Failure to achieve compliance as the result of a Notice to Cure may result in the imposition of a Sanction.

Sanction

A Sanction is a penalty assessed or applied for failure to demonstrate compliance in one or more areas of contractual responsibility. A sanction may take the form of a monetary penalty; an enrollment cap; or other actions as deemed appropriate by AHCCCS.


ADHS/DBHS

United Healthcare Community Plan
Arizona Physicians IPA (Prior to 10/1/13)

United Healthcare Community Plan - CRS
Arizona Physicians IPA - CRS (Prior to 10/1/13)

Bridgeway Health Solutions

Care 1st Health Plan

DES/CMDP

Health Choice Arizona

Health Net Access

Maricopa Health Plan

Mercy Care Plan

Phoenix Health Plan

Pima

University Family Care



Corrective Action Plans Notices to Cure Sanctions

Contact

Administrative Action documents are updated on a periodic and regular basis.

For questions about Acute Care health plan actions email Cynthia.Deluca@azahcccs.gov.

 

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