1. A. The Department may take an action listed in subsection (B) against a ground ambulance service that:

   1. 1. Fails or has failed to comply with any provision in A.R.S. Title 36, Chapter 21.1;
   2. 2. Fails or has failed to comply with any provision in this Article or Article 2, 10, or 11 of this Chapter;
   3. 3. Does not submit a corrective action plan, as provided in R9-25-903(A)(6), R9-25-908(G)(4)(a), R9-25-908(H)(3)(a), R9-25-908(K)(1)(c), or R9-25-910(E)(2), that is acceptable to the Department;
   4. 4. Does not complete a corrective action plan submitted according to R9-25-903(A)(8) or R9-25-910(E)(2); or
   5. 5. Knowingly or negligently provides false documentation or false or misleading information to the Department or to a patient, third-party payor, or other person billed for service.

2. B. The Department may take the following actions against a ground ambulance service:

   1. 1. Except as provided in subsection (B)(3), after notice and an opportunity to be heard is provided under A.R.S. Title 41, Chapter 6, Article 10, suspend:

      1. a. The ground ambulance service’s certificate of necessity, or
      2. b. The certificate of registration of a ground ambulance vehicle operated by the ground ambulance service;

   2. 2. After notice and an opportunity to be heard is provided under A.R.S. Title 41, Chapter 6, Article 10, revoke:

      1. a. The ground ambulance service’s certificate of necessity, or
      2. b. The certificate of registration of a ground ambulance vehicle operated by the ground ambulance service;

   3. 3. As permitted under A.R.S. §§ 36-2234(N) and 41-1092.11(B), if the Department determines that the public health, safety, or welfare imperatively requires emergency action and incorporates a finding to that effect in the Department’s order, immediately suspend:

      1. a. The ground ambulance service’s certificate of necessity pending proceedings for revocation or other action, or
      2. b. The certificate of registration of a ground ambulance vehicle operated by the ground ambulance service pending proceedings for revocation or other action; or
   4. 4. Another enforcement action according to A.R.S. § 36-2245(I), (J), or (K).

3. C. In determining the type of enforcement action to impose under A.R.S. § 36-2245, the Director shall consider:

   1. 1. The severity of the violation relative to public health and safety;
   2. 2. The number of violations relative to the annual transport volume of the certificate holder;
   3. 3. The nature and circumstances of the violation;
   4. 4. Whether the violation was corrected, the manner of correction, and the time-frame involved;
   5. 5. The duration of each violation;
   6. 6. The frequency and nature of complaints received by the Department about a certificate holder; and
   7. 7. The impact of the penalty or assessment on the provision of ambulance response or transport in the certificate holder’s service area.

Historical Note

New Section adopted by final rulemaking at 7 A.A.R. 1098, effective February 13, 2001 (Supp. 01-1). R9-25-911 repealed; new R9-25-911 renumbered from R9-25-912 and 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).