B Decision Letters
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B Decision Letters

 

 

Revised 03/29/2022

Policy

All customers must receive a letter explaining the decision on their renewal. See MA1604 for information regarding written letters.

When a letter generated by HEAplus appears to be incorrect, see Procedures for Manual Letters for instructions.

Definitions

Term

Definition

Decision Letter

A letter that notifies a customer of the action taken for their AHCCCS Medical Assistance program eligibility including:

  • Approval;

  • Denial;

  • Discontinuance;

  • Change in share of cost, premium amount or co-payments;

  • Change in eligible medical services; and

  • Enrollment with a health plan or program contractor.

 

Legal Authority

Program

Legal Authorities

All Programs

42 CFR 435.916

42 CFR 435.919