Ariz. Admin. Code § 9-9A-104

Current through Register Vol. 30, No. 50, December 13, 2024

Section R9-9A-104 - Application for Licensure

A. A person may not act as a procurement organization in this state unless the person is licensed by the Department as a procurement organization.

B. An applicant for a procurement organization license shall submit to the Department an application that contains:

1. The following, according to A.R.S. § 36-851.01(A), in a Department-provided format:

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. Physical address;

ii. Mailing address, if different from the physical address;

iii. Telephone number;

iv. Email address; and

v. Tax ID number;

c. Whether the applicant is a business organization and, if so, the type of business organization;

d. Whether the applicant is accredited as a procurement organization;

e. If the applicant is not accredited as a procurement organization, the name, email address, telephone number, and professional license number of the medical director;

f. Whether the facility is ready for a licensing inspection by the Department;

g. If the facility is not ready for a licensing inspection specified in subsection (B)(1)(f), the date the facility will be ready for a licensing inspection;

h. The name, title, and contact information of an individual acting on behalf of the applicant, as specified in R9-9A-103;

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

j. Whether the applicant agrees to allow the Department to submit supplemental requests for information under R9-9A-109; and

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

2. If applicable, documentation that the procurement organization is accredited;

3. A floor plan, drawn to scale, of each building where the procurement organization will be located, showing the function of each room;

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

5. Documentation that shows that the applicant is in good standing with the Arizona Corporation Commission; and

6. An application fee of $2,000.

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

D. The Department shall issue or deny a license to an applicant as specified in R9-9A-109.

Ariz. Admin. Code § R9-9A-104

New Section made by final expedited rulemaking at 30 A.A.R. 3657, effective 11/5/2024.