Southwest Ambulance, Inc. v. Arizona Department of Health Services

902 P.2d 1362, 183 Ariz. 258, 185 Ariz. Adv. Rep. 30, 1995 Ariz. App. LEXIS 59
CourtCourt of Appeals of Arizona
DecidedMarch 7, 1995
Docket1 CA-CV 92-0476
StatusPublished
Cited by6 cases

This text of 902 P.2d 1362 (Southwest Ambulance, Inc. v. Arizona Department of Health Services) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Southwest Ambulance, Inc. v. Arizona Department of Health Services, 902 P.2d 1362, 183 Ariz. 258, 185 Ariz. Adv. Rep. 30, 1995 Ariz. App. LEXIS 59 (Ark. Ct. App. 1995).

Opinion

OPINION

KLEINSCHMIDT, Judge.

The Arizona Department of Health Services appeals from a ruling of the trial court that ambulance rate schedules issued by the Department were invalid because they were not promulgated according to law. We believe that the trial court was correct, and we affirm its judgment. We have no record of what occurred in the administrative hearings which are referred to throughout this opinion. We base our understanding of what occurred in those proceedings on what the parties describe in their briefs.

FACTS AND PROCEDURAL BACKGROUND

Prior to 1982, Arizona ambulance companies were regulated by the Arizona Corporation Commission as public service corporations “carrying persons ... for hire.” Ariz. Const, art. XV, § 2 historical note; Emergency Medical Transport, Inc. v. City of Tempe, 157 Ariz. 260, 261, 756 P.2d 929, 930 (App.1988). Ambulance companies were deregulated as a result of a 1980 general election referendum. Emergency Medical Transport, 157 Ariz. at 261, 756 P.2d at 930. In November 1982, as a result of another *260 general election referendum, ambulance companies were again made subject to regulation, not by the Corporation Commission, but by the legislature. Id.; Ariz. Const, art. XXVII, § 1. Consequently, the legislature enacted Arizona Revised Statutes Annotated (“A.R.S.”) sections 36-2232 to 36-2244 to provide for the mandated regulation. 1983 Ariz.Sess.Laws, Ch. 324, § 1, effective May 5, 1983; Emergency Medical Transport, 157 Ariz. at 261, 756 P.2d at 930. The legislature delegated the responsibility for regulation to the Director of the Department of Health Services. A.R.S. § 36-2232; Emergency Medical Transport, 157 Ariz. at 261, 756 P.2d at 930.

In 1985, Southwest Ambulance, Inc., was a party in an administrative hearing held by the Department of Health Services to determine which applicants would receive certificates of necessity to operate ambulances in the Phoenix area. As a part of the same hearing, the Department intended to establish rates and charges for the ambulance companies, as required by A.R.S. section 36-2234. During this proceeding, the Department produced “Ambulance Service Schedule Number One” which was used to establish the rates and other criteria the Department intended to impose on the ambulance companies. Southwest successfully objected to the admission of this schedule into, evidence, arguing that since the document contained matters that pertained generally to ambulance service companies statewide, it should have been promulgated as an administrative rule. The procedure relating to the adoption of administrative rules is spelled out in the Administrative Procedures Act, AR.S. sections 41-1001 through 41-1071, and requires much more in the way of public notice and comment than the notice required for an ordinary rate hearing. The contested document was not admitted into evidence.

After the hearing, the Department issued a decision and order which was followed by a schedule of rates and charges that ambulance service companies operating in the Phoenix area, including Southwest, could charge. The schedule, which was similar to the “Ambulance Service Schedule Number One” which had been presented but not admitted into evidence at the rate hearing, contained more than just the dollar amounts the companies could charge. For example, it specified rules as to how fractions of an hour were to be charged, how the transport of multiple patients was to be charged, how standby charges could be calculated, and when a higher advanced life support rate, as opposed to basic life support rate, could be charged. Southwest disputes that the Director actually approved and adopted the schedules as to when the higher advanced life support rate could be charged.

Southwest requested a rehearing of the rate decision. This request was denied. It then brought an action under the Administrative Review Act, A.R.S. sections 12-901 through 12-914, appealing the decision with regard to the dollar amounts the Department had set. It did not, however, challenge anything else about the validity of the schedules. The record does not disclose the outcome of the administrative action.

In 1987, a public hearing was held on Southwest’s application for a certificate of necessity for service and to establish rates and charges for service in the Casa Grande area. After the hearing, the Department issued a decision and an order setting rates for service in Casa Grande. Later, the Department prepared and issued a rate schedule, which reflected the rates in the rate decision and order. Apparently, Southwest never objected tp this schedule.

In 1988, the Department held a public rate hearing and issued a decision and order approving a rate adjustment for ambulance companies in the Phoenix metropolitan area, which it referred to as the “Phoenix Group.” The Department accepted a stipulation by the members of the Phoenix Group, including Southwest, wherein new rates and charges consistent with the Department’s “Ambulance Service Schedule Number Two” were agreed to. Again, Southwest disputes that the stipulation included an agreement as to when the ambulance companies could charge for advanced life support services.

As alluded to earlier, there is a difference in the rates allowed for advanced life support, as opposed to basic life support, services. Advanced life support refers to the *261 more sophisticated service provided by paramedics or intermediate emergency medical technicians. See A.A.C. R9-13-201(4). Basic life support is performed by basic emergency medical technicians who do not have the same level of training as paramedics or intermediate emergency medical technicians. See A.A.C. R9-13-201(14).

Shortly after the Department had assumed responsibility for regulating ambulance companies, it adopted a Uniform Chart of Accounts (later renamed the Uniform Reports ing Guide) which required the companies to provide financial data regarding their operation to the Department and described how rates should be charged. Under the Uniform Chart of Accounts, the determination of when advanced life support rates could be charged was different from that under the schedules. Apparently, after the 1985 hearings, there was some confusion as to which method of determining advanced life support rates controlled. The Department maintains that the schedules controlled after the 1985 hearings while Southwest argues that the Uniform Chart of Accounts, which it was operating under, controlled.

In late 1989, a Department employee, who apparently recognized the inconsistency between the schedules and the Uniform Chart of Accounts, sent a letter to all ambulance companies directing that advanced life support and basic life support charges were to be assessed in accordance with the schedules rather than the Uniform Chart of Accounts or the Uniform Reporting Guide. The schedules provided:

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Bluebook (online)
902 P.2d 1362, 183 Ariz. 258, 185 Ariz. Adv. Rep. 30, 1995 Ariz. App. LEXIS 59, Counsel Stack Legal Research, https://law.counselstack.com/opinion/southwest-ambulance-inc-v-arizona-department-of-health-services-arizctapp-1995.