St. Joseph's Hospital v. Arizona Health Care Cost Containment System

OPINION

FIDEL, Judge.

This case arises from the denial by the Maricopa County Health Plan (“MCHP”)— an Arizona Health Care Cost Containment System (“AHCCCS”) contract provider—of a reimbursement claim submitted by St. Joseph’s Hospital and Medical Center (“St. Joseph’s”) for emergency treatment and hospitalization of an MCHP member. MCHP denied reimbursement because St. Joseph’s failed to give MCHP timely notice *311that it was treating a member of the MCHP plan. The AHCCCS director upheld the denial of reimbursement on administrative review, but the superior court reversed the agency’s decision on…