Information about Submitting Cost Reports

Dear Home Health Licensee:

Under the authority of Arizona Revised Statutes §§ 36-125.04 and 36-436, the Department revised the rules in Arizona Administrative Code, Title 9, Chapter 11, to specify requirements for home health  agency financial reporting.  The revised rules were approved by the Governor’s Regulatory Review Council and filed with the Secretary of State on October 2, 2007. The rules specifying requirements for home health agency financial reports are available on the Secretary of State’s web site at: http://www.azsos.gov/public_services/Title_09/9-11.rtf .  If you wish a courtesy hard copy of the Title 9, Chapter 11, rules please contact us.

These rules were effective on December 1, 2007.

There is one licensed home health agency reporting requirement. All home health agency’s are required to keep their existing schedule of Rates and Charges on file with the Department.  The office policy will be to receive a current and complete rates and charges report from each home health agency once a year.  If an home health agency makes changes to its rates and charges during the year, please submit a new rates and charges report at the end of the calendar quarter in which the change was made.

• Rates and Charges Form – [XLS 74K]
  • Submit as an e-mail attachment to the Cost Reporting staff listed below.
• Attestation of Completeness and Accuracy [DOC 33K], completed by the home health agency administrator
• Print and mail a hard copy of the Attestation of Completeness and Accuracy to:

Martha LaVoy, Financial Reporting Manager
150 N. 18th Ave., Suite 550
Phoenix, AZ  85007-3248

Contacts