AHCCCS Exclusion List

Date: 02/25/25

AHCCCS Exclusion List

Providers are encouraged to check the AHCCCS Exclusion List regularly, and prior to hiring or contracting with staff and/or partnering with an individual or organization to provide services to AHCCCS members. AHCCCS will deny prior authorizations or claims submitted by a provider which include the use of an excluded entity or individual.  

The AHCCCS Exclusion List and information about exclusion can be found here.

Under A.R.S. § 36-2930.05, AHCCCS may exclude providers pursuant to rules adopted by AHCCCS, which are outlined in Arizona Administrative Code (A.A.C.) Title 9, Chapter 22, Article 18. AHCCCS, in its sole discretion, may exclude entities and individuals for any of the reasons outlined in A.A.C. R9-22-1802. A.R.S. Sec. 36-2930.05(E) defines "exclude" as: "items and services furnished, ordered or prescribed by a specified individual or entity will not be reimbursed by the administration, a contractor or any agent of the administration or a contractor. Exclude includes the termination of a provider agreement or the administration's refusal to enter into a provider agreement." 

 

If you have questions, please contact your AzCH Provider Engagement Specialist. To obtain the contact information of you assigned AzCH Provider Engagement Specialist, please email us at AzCHProviderEngagement@azcompletehealth.com.