1. 1. The statutory basis for the penalty, assessment, or the penalty and assessment;
2. 2. Identification of the state or federal regulation and state or federal law that AHCCCS alleges has been violated;
3. 3. The factual basis for AHCCCS’ determination that the penalty, assessment, or the penalty and assessment should be imposed;
4. 4. The amount of the penalty, assessment, or penalty and assessment;
5. 5. The process for the person to accept or request a compromise of the penalty, assessment, or penalty and assessment; and
6. 6. The process for requesting a State Fair Hearing.

If AHCCCS imposes a penalty, assessment, or a penalty and assessment, AHCCCS shall hand deliver or send by certified mail return receipt requested or Federal Express to the person, a written Notice of Intent to impose a penalty, assessment, or a penalty and assessment. The Notice of Intent shall include:

Historical Note

New Section made by final rulemaking at 10 A.A.R. 3056, effective September 11, 2004 (Supp. 04-3). Amended by final rulemaking at 17 A.A.R. 2615, effective February 4, 2012 (Supp. 11-4).