Arizona
LLC
Website link to register:
https://www.azcc.gov/divisions/corporations
Naming conventions
Name cannot suggest it is a corporation or government entity. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” Professional services must use “PLLC” or “Professional Limited Liability Company.”
Licensing Requirements
PLLC members must hold licenses from the Arizona Medical Board.
Malpractice insurance required for all practitioners. Comply with Arizona Department of Health Services’ facility requirements.
Required documentation for medical practices
Articles of Organization, Operating Agreement, Malpractice Insurance, Controlled Substances Certificate, Professional Licenses
Filing Fee: $50
Annual/BIennial Fee: None
Additional Notes: No annual report requirement for LLCs.
Medicaid
Program Name: Arizona Health Care Cost Containment System (AHCCCS)
Official Website: http://azahcccs.gov
Legislation: Arizona does not have specific DPC legislation but recognizes DPC as a model of healthcare delivery.
Private Contracting
Private contracting is allowed. Medicaid-related services must follow state and federal Medicaid regulations.
Restrictions
No specific restrictions on DPC practices, but federal Medicaid guidelines must be followed.
Medicaid Program
Arizona Health Care Cost Containment System (AHCCCS) manages Medicaid, offering coverage to low-income residents.
Notification Requirements
Notification required to clarify non-Medicaid acceptance.
Provider Enrollment Requirements
Providers must enroll with AHCCCS to serve Medicaid beneficiaries directly or offer reimbursable services.
Enrollment Options
"Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may not have Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot be Medicaid PCPs unless fully enrolled.
Billing and Reimbursement
DPC practices typically do not bill AHCCCS for services covered under private agreements.
Managed Care Plan Exemptions
Exemptions apply for risk-based managed care plans.
Billing Clarity
Cannot bill Medicaid patients for covered services without written consent.
CMS Guidance
Streamlined enrollment guidance available from CMS.
Opportunities for Collaboration
Explore collaboration with AHCCCS for innovative care delivery models.
State-Specific Notes
Health First Arizona offers collaborative opportunities for primary care innovation.
Dispensing Medication
Board of Pharmacy Official Link: https://pharmacy.az.gov/
State Licensing
Dispensing allowed with a medical license; separate registration for controlled substances required.
Scope of Practice
Allowed for non-controlled and controlled substances, provided all regulations are met.
Inventory Management
Maintain complete inventory records, especially for controlled substances.
Record-Keeping
Record-keeping is mandatory; compliance with HIPAA and state privacy laws is required.
Dispensing Standards
Labels must meet Arizona Board of Pharmacy standards, including patient information, dosage, and physician details.
Controlled Substances
Physicians must comply with Arizona’s controlled substances regulations, including PDMP reporting.
Billing and Reimbursement
Comply with Arizona and federal billing guidelines; avoid practices that violate Stark Law.
Federal Compliance
Adherence to federal compliance, including DEA and OSHA regulations, is mandatory.
State Pharmacy Laws
Separate registration with the Arizona State Board of Pharmacy is required for controlled substances dispensing.
Patient Consent
Patients must provide consent and be informed about dispensed medications.
Insurance and Liability
Physicians must ensure liability insurance includes dispensing coverage.
Training Requirements
State-specific training is required for controlled substances.
Audits and Inspections
Inspections are conducted regularly by Arizona’s medical board to ensure compliance.