As a program contractor for Arizona Health Care Cost Containment System (AHCCCS), SCAN is required to establish a network of contracted providers adequate to ensure that critical care services are provided without gaps. In addition, SCAN shall resolve unforeseeable gaps in critical services within tow hours of the gap being reported.

What is a gap in service?

A gap in service is the difference between the number of hours of home care worker critical service scheduled in each individual’s Home & Community Based Service (HCBS) service plan and the hours of the scheduled type of critical service that are actually provided to the member.

What is a non-provision of service?

A non-provision of service is when the authorized services are not provided as scheduled, when scheduled services are no longer available because a replacement cannot be found.

All contracted provider for these critical care services (Attendant Care, Personal Care, Housekeeping, and Respite Care) are required to ensure that this requirement is being met and information is accurately reported. Any non-provision of service must be reported to SCAN by the 5th business day of every month. If the 5th calendar day of the month falls on a weekend, it is expected that the report will be submitted the last business day prior to the 5th.

Critical care providers must also have 24 hour phone coverage. Acceptable coverage can be handled by an answering service, a pager or after-hours cell number. Calls placed to the agency after-hours must be answered immediately or must be returned within 15 minutes of message being left.

Click on the links below for more information on reporting non-provisions of service and instructions for completing the report.

ACOM Policy, click here

For additional questions, please contact Network Management Services at AZNetMgmt@scanhealthplan.com.