Ariz. Admin. Code § 9-25-1101

Current through Register Vol. 30, No. 50, December 13, 2024

Section R9-25-1101 - Establishing Initial General Public Rates (Authorized by A.R.S. Sections 36-2232, 362239)

A. As provided in R9-25-902(A)(19), an applicant wanting to establish initial general public rates as part of an application for an initial certificate of necessity shall include the following in the application packet submitted to the Department according to R9-25-902(A):

1. A copy of the applicant's financial statements, covering the most recent consecutive 12-month period;

2. A copy of the purchase agreements or lease agreements listed according to R9-25-902(A)(17), if not already submitted according to R9-25-902(A)(28);

3. For all business organizations or governmental entities affiliated with the applicant listed according to R9-25-902(A)(1)(d), the methodology and calculations used in allocating costs among the applicant and government entities or profit or not-for-profit businesses;

4. Other documents, exhibits, or statements that may assist the Department in setting the general public rates; and

5. Any other information or documents requested by the Director to clarify or complete the application.

B. A certificate holder applying for initial general public rates shall submit to the Department:

1. The following information, in a Department-provided format:

a. The identifying number on the certificate holder's current certificate of necessity;

b. The legal business or corporate name, address, telephone number, and facsimile number of the ground ambulance service;

c. Any other names by which the certificate holder is known;

d. The names of all other business organizations or governmental entities operated by the certificate holder related to the ground ambulance service;

e. The name, title, address, e-mail address, and telephone number of the following:

i. Each certificate holder and individual responsible for managing the ground ambulance service,

ii. The individual acting for the certificate holder according to R9-25-102,

iii. The individual to contact to access the ground ambulance service's records required in R9-25-908(B), and

iv. The statutory agent for the ground ambulance service or the individual designated by the certificate holder to accept service of process and subpoenas for the ground ambulance service;

f. The requested general public rates;

g. Whether the certificate holder agrees to allow the Department to submit supplemental requests for information under R9-25-1201(C)(3);

h. Attestation that the information or documents submitted to the Department are true and correct; and

i. The signature of the individual acting for the certificate holder according to R9-25-102 and the date signed;

2. A copy of the certificate holder's financial statements, covering the most recent consecutive 12-month period;

3. A projected Ambulance Revenue and Cost Report covering the first consecutive 12 months of operation under the requested general public rates in subsection (B)(1)(f);

4. A copy of all actual or anticipated purchase agreements or lease agreements to be used in connection with the ground ambulance service, including the monetary amount and duration of each agreement, for:

a. Real estate,

b. Ground ambulance vehicles, or

c. Equipment exceeding $10,000;

5. For all business organizations or governmental entities affiliated with the certificate holder listed according to subsection (B)(1)(d), the methodology and calculations used in allocating costs among the certificate holder and business organizations or governmental entities;

6. Other documents, exhibits, or statements that may assist the Department in setting the general public rates; and

7. Any other information or documents requested by the Director to clarify or complete the application.

C. Each certificate holder requesting to apply for a uniform general public rate under A.R.S. § 36-2232(E) shall submit to the Department:

1. The information required in subsection (B)(1);

2. The documents required in subsections (B)(4) through (7);

3. A copy of the certificate holder's financial statements, covering the most recent consecutive 24-month period;

4. Projected Ambulance Revenue and Cost Reports covering the first consecutive 24 months of operation under the requested general public rates in subsection (B)(1)(f); and

5. A document signed by each certificate holder requesting to apply for a uniform general public rate under A.R.S. § 36-2232(E).

D. The Department shall review an application under subsection (B) or (C) according to R9-25-1106, R9-25-1107, and R9-25-1201 and approve or deny the application according to A.R.S. § 36-2232 and Article 12 of this Chapter.

Ariz. Admin. Code § R9-25-1101

New Section adopted by final rulemaking at 7 A.A.R. 1098, effective February 13, 2001 (Supp. 01-1). Amended by final rulemaking at 30 A.A.R. 581, effective 3/7/2024.