Arizona Administrative Code
Title 9 - HEALTH SERVICES
Chapter 9 - DEPARTMENT OF HEALTH SERVICES - PROCUREMENT ORGANIZATIONS
Article 1 - PROCUREMENT ORGANIZATION LICENSURE
Section R9-9-104 - Application for Licensure

Universal Citation: AZ Admin Code R 9-9-104

Current through Register Vol. 30, No. 38, September 20, 2024

A. An applicant applying for a procurement organization license shall submit an application packet that contains:

1. An application, in a Department-provided format, according to A.R.S. § 36-851.01(A) that includes:
a. The applicant's name, mailing address, email address, and telephone number;

b. The name or proposed name of the procurement organization, including the:
i. Business street address;

ii. Business mailing address, if different from the street address;

iii. Telephone number;

iv. Email address; and

v. Tax ID number;

c. If part of a business institution, the institution's:
i. Name;

ii. Street address;

iii. Mailing address, if different from the street address;

iv. Telephone number; and

v. Email address;

d. Whether the procurement organization is ready for a licensing inspection by the Department, if applicable;

e. If the procurement organization is not ready for a licensing inspection specified in (d), the date the Department may perform a licensing inspection, if applicable;

f. The name and contact information of an individual acting on behalf of the applicant specified in R9-9-103, if applicable;

g. If applicable, the medical director's:
i. Name,

ii. Telephone number,

iii. Email address, and

iv. License number;

h. Whether the applicant complies with local zoning ordinances, building codes, and fire codes;

i. Whether the applicant agrees to allow the department to submit supplemental requests for information under R9-9-108; and

j. The applicant's signature and the date signed;

2. A copy of the procurement organization's current certificate of accreditation from an accrediting body, if applicable;

3. Documentation for the applicant that complies with A.R.S. § 41-1080;

4. A copy of the procurement organization labeled floor plan, including technical and administrative function areas, if applicable; and

5. A licensing fee of $2,000.

B. Upon receipt of the application packet in subsection (A), the Department shall conduct an inspection of the procurement organization, if applicable.

C. The Department shall issue or deny a license to an applicant as specified in R9-9-108.

Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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