Section R9-15-206. Primary Care Provider Eligibility Criteria

A.       To be eligible to participate in the PCPLRP, a primary care provider shall:

1.        Be a United States citizen;

2.        Have completed the final year of a course of study or pro- gram approved by an accrediting agency recognized by the United States Department of Education or the Council for Higher Education Accreditation for higher education in a health profession licensed under A.R.S. Title 32;

3.        Hold a current Arizona license or certificate in good standing in a health profession licensed under A.R.S. Title 32;

4.        If a physician, have completed a professional residency program and be board certified or eligible to sit for the certifying examination in:

a.        Family or general practice,

b.        Pediatrics,

c.        Obstetrics, or

d.        Internal medicine;

5.        Have a signed contract for current or prospective employ- ment at an eligible service site or a letter of intent signed by the individual in the senior leadership position at an eligible service site indicating an intent to hire the pri- mary care provider;

6.        Agree to contract with the Department to serve full-time providing primary care services at the eligible service site for a minimum of 24 months, with 12- or 24-month con- tract extensions available upon mutual agreement with the individual in the senior leadership position at the ser- vice site;

7.        Agree, unless an obstetrician or nurse midwife, to work at least 32 of the minimum 40 hours per week providing ambulatory care services at the service site during sched- uled office hours;

8.        Agree, if an obstetrician or nurse midwife, to work at least 21 hours per week providing ambulatory care ser- vices at the service site during scheduled office hours;

9.        Agree to charge for services at the usual and customary rates prevailing in the primary care area, except that patients unable to pay the usual and customary rates shall be charged a reduced rate according to the service site’s sliding-fee scale based on poverty level or not charged;

10.     Agree not to discriminate on the basis of a patient’s abil- ity to pay for care or the payment source, including Medi- care or AHCCCS;

11.     Agree to accept assignment for payment under Medicare and to participate in AHCCCS; and

12.     Have satisfied any other obligation for health  profes- sional service owed under a contract with a federal, state, or local government or another entity before beginning a period of service under the PCPLRP.

B.       The following are not eligible to participate:

1.        A primary care provider who has breached a health pro- fessional services contract with a federal, state, or local government or another entity;

2.        A primary care provider against whose property there is a judgment lien for a debt to the United States; and

3.        A primary care provider who is in a for-profit practice.

Historical Note

New Section made by final rulemaking at 7 A.A.R. 2823, effective August 9, 2001 (Supp. 01-2).