R9-25-911. Enforcement Action (Authorized by A.R.S. §§

36-2234(L), 36-2244, 36-2245, 41-1092.03, 41-1092.11(B)) A. The Department may take an action listed in subsection (B) against a ground ambulance service that: 1. Fails or has failed to comply with any provision in A.R.S. Title 36, Chapter 21.1; 2. Fails or has failed to comply with any provision in this Article or Article 2, 10, or 11 of this Chapter; 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. Does not complete a corrective action plan submitted according to R9-25-903(A)(8) or R9-25-910(E)(2); or 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. B. The Department may take the following actions against a ground ambulance service: 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: a. The ground ambulance service’s certificate of necessity, or b. The certificate of registration of a ground ambulance vehicle operated by the ground ambulance service; 2. After notice and an opportunity to be heard is provided under A.R.S. Title 41, Chapter 6, Article 10, revoke: a. The ground ambulance service’s certificate of necessity, or b. The certificate of registration of a ground ambulance vehicle operated by the ground ambulance service; 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: a. The ground ambulance service’s certificate of necessity pending proceedings for revocation or other action, or 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. Another enforcement action according to A.R.S. § 36- 2245(I), (J), or (K). C. In determining the type of enforcement action to impose under A.R.S. § 36-2245, the Director shall consider: 1. The severity of the violation relative to public health and safety; 2. The number of violations relative to the annual transport volume of the certificate holder; 3. The nature and circumstances of the violation; 4. Whether the violation was corrected, the manner of correction, and the time-frame involved; 5. The duration of each violation; 6. The frequency and nature of complaints received by the Department about a certificate holder; and 7. The impact of the penalty or assessment on the provision of ambulance response or transport in the certificate holder’s service area.