36-2239

36-2239. Rates or charges of ambulance
service

A. An ambulance service that applies for an adjustment in its rates or charges
shall automatically be granted a rate increase equal to the amount determined under
section 36-2234, subsection E, if the ambulance service is so entitled. An automatic rate
adjustment that is granted pursuant to this subsection and that is filed on or before
April 1 is effective June 1 of that year. The department shall notify the applicant and
each health care services organization as defined in section 20-1051 of the rate
adjustment on or before May 1 of that year.

B. Notwithstanding subsection E of this section, if the department does not hold a
hearing within ninety days after an ambulance service submits an application to the
department for an adjustment of its rates or charges, the ambulance service may adjust
its rates or charges to an amount not to exceed the amount sought by the ambulance
service in its application to the department. An ambulance service shall not apply for an
adjustment of its rates or charges more than once every six months.

C. At the time it holds a hearing on the rates or charges of an ambulance service
pursuant to section 36-2234, the department may adjust the rates or charges adjusted by
the ambulance service pursuant to subsection B of this section, but the adjustment shall
not be retroactive.

D. Except as provided in subsection H of this section, an ambulance service shall
not charge, demand or collect any remuneration for any service greater or less than or
different from the rate or charge determined and fixed by the department as the rate or
charge for that service. An ambulance service may charge for disposable supplies,
medical supplies and medication and oxygen related costs if the charges do not exceed the
manufacturer's suggested retail price, are uniform throughout the ambulance service's
certificated area and are filed with the director. An ambulance service shall not refund
or limit in any manner or by any device any portion of the rates or charges for a service
which the department has determined and fixed or ordered as the rate or charge for that
service.

E. The department shall determine and render its decision regarding all rates or
charges within ninety days after commencement of the applicant's hearing for an
adjustment of rates or charges. If the department does not render its decision as
required by this subsection, the ambulance service may adjust its rates and charges to an
amount that does not exceed the amounts sought by the ambulance service in its
application to the department. If the department renders a decision to adjust the rates
or charges to an amount less than that requested in the application and the ambulance
service has made an adjustment to its rates and charges that is higher than the
adjustment approved by the department, within thirty days after the department's decision
the ambulance service shall refund to the appropriate ratepayer the difference between
the ambulance service's adjusted rates and charges and the rates and charges ordered by
the department. The ambulance service shall provide evidence to the department that the
refund has been made. If the ambulance service fails to comply with this subsection, the
director may impose a civil penalty subject to the limitations provided in section
36-2245.

F. An ambulance service shall charge the advanced life support base rate as
prescribed by the director under any of the following circumstances:

1. A person requests an ambulance by dialing telephone number 911, or a similarly
designated telephone number for emergency calls, and the ambulance service meets the
following:

(a) The ambulance is staffed with at least one ambulance attendant.

(b) The ambulance is equipped with all required advanced life support medical
equipment and supplies for the advanced life support attendants in the ambulance.

2. Advanced life support is requested by a medical authority or by the patient.

3. The ambulance attendants administer one or more specialized treatment activities
or procedures as prescribed by the department by rule.

G. An ambulance service shall charge the basic life support base rate as prescribed
by the director under any of the following circumstances:

1. A person requests an ambulance by dialing telephone number 911, or a similarly
designated telephone number for emergency calls, and the ambulance service meets the
following:

(a) The ambulance is staffed with two ambulance attendants certified by this state.

(b) The ambulance is equipped with all required basic life support medical
equipment and supplies for the basic life support medical attendants in the ambulance.

2. Basic life support transportation or service is requested by a medical authority
or by the patient, unless any provision of subsection F of this section applies, in which
case the advanced life support rate shall apply.

H. For each contract year, the Arizona health care cost containment system
administration and its contractors and subcontractors shall provide remuneration for
ambulance services for persons who are enrolled in or covered by the Arizona health care
cost containment system in an amount equal to eighty per cent of the amounts as
prescribed by the department as of July 1 of each year for services specified in
subsections F and G of this section and eighty per cent of the mileage charges as
determined by the department as of July 1 of each year pursuant to section 36-2232. The
Arizona health care cost containment system administration shall make annual adjustments
to the Arizona health care cost containment system fee schedule according to the
department's approved ambulance service rate in effect as of July 1 of each year. The
rate adjustments made pursuant to this subsection are effective beginning October 1 of
each year.

I. In establishing rates and charges the director shall consider the following
factors:

1. The transportation needs assessment of the medical response system in a
political subdivision.

2. The medical care consumer price index of the United States department of labor,
bureau of labor statistics.

3. Whether a review is made by a local emergency medical services coordinating
system in regions where that system is designated as to the appropriateness of the
proposed service level.

4. The rate of return on gross revenue.

5. Response times pursuant to section 36-2232, subsection A, paragraph 2.

J. Notwithstanding section 36-2234, an ambulance service may charge an amount for
medical assessment, equipment or treatment that exceeds the requirements of section
36-2205 if requested or required by a medical provider or patient.

K. Notwithstanding subsections D, F and G of this section, an ambulance service may
provide gratuitous services if an ambulance is dispatched and the patient subsequently
declines to be treated or transported.