A. A certificate holder applying for approval of a contract rate or range of rates under A.R.S. § 36-2234(I) shall submit to the Department:
1. The following information, in a Department-provided format:
- a. The name of the certificate holder,
- b. The identifying number on the certificate holder’s current certificate of necessity,
- c. A statement that the certificate holder is making the request under A.R.S. § 36-2234(I),
- d. The contract rate or range of rates being requested,
- e. The effective date of the requested contract rate or range of rates,
- f. An attestation that the information and documents provided by the certificate holder are true and correct, and
- g. The signature of the individual acting for the certificate holder according to R9-25-102 and the date signed; and
2. Information demonstrating the cost and economics of providing the transports for the requested contract rate or range of rates, such as:
- a. A copy of the certificate holder’s most recent Ambulance Revenue and Cost Report; and
- b. A projected Ambulance Revenue and Cost Report covering the first consecutive 12 months of operation under the requested contract rate or range of rates in subsection (A)(1)(d).
B. A certificate holder applying for approval of a contract rate or range of contract rates under A.R.S. § 36-2234(K) shall submit to the Department:
- 1. The information in subsection (A)(1), in a Department-provided format; and
- 2. The documents required in R9-25-1102(B)(2) through (8).
- C. The Department shall review an application under this Section according to R9-25-1106, R9-25-1107, and R9-25-1201 and approve or deny the application according to A.R.S. §§ 36-2234 and 36-2239 and Article 12 of this Chapter.
Historical Note
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 (March 29, 2024), with an immediate effective date of March 7, 2024 (Supp. 24-1).