Ariz. Admin. Code § R20-5-1402 - Reimbursement Claims

A. A Municipal Payor seeking reimbursement from the Fund shall submit a reimbursement claim in writing on the Municipal Firefighter Cancer Reimbursement Form approved by the Commission.

B. The Municipal Firefighter Cancer Reimbursement Form shall include the following attestations, which shall be made by an autho- rized representative of a Municipal Payor seeking reimbursement from the Fund:

1. The reimbursement request includes only eligible compensation and benefits paid under A.R.S. § 23-1702(A) on municipal fire- fighter or municipal fire investigator workers' compensation claims accepted under A.R.S. § 23-901.09.

2. The reimbursement request only includes amounts actually paid by th e Municipal Payor for comp ensation and benefits under A.R.S. § 23-1702(A) during the immediately preceding fiscal year.

3. The reimbursement request does not include amounts paid for expenses relating to case management, vocational rehabilitation, or similar nonmedical costs.

4. The information included in, or submitted with, the Municipal Firefighter Cancer Reimbursement Form is true and correct.

C. The Municipal Firefighter Cancer Reimbursement Form shall not be changed, amended, or otherwise altered without the prior written approval of the Commission.

D. A Municipal Payor seeking reimbursement from the Fund for compensation and benefits paid during a fiscal year shall submit a reim- bursement claim to the Commission between July 1 and August 31 immediately following the applicable fiscal year.

E. Failure to timely submit a reimbursement claim for compensation and benefits paid during a fiscal year before the claim submission deadline in subsection D will be deemed a waiver of the right of the Municipa l Payor to request reim bursement for amounts paid during the applicable fiscal year. Failure to include all eligible compensation or benefits in a reimbursement claim before the claim submission deadline in subsection D will be deemed a waiver of the right of the Muni cipal Payor to request reimbursement for an y omitted amounts paid during the applicable fiscal year.

F. The Commission shall process reimbursements pursuant to A.R.S. § 23-1702(C) on or before December 31 of each year.

G. The maximum annual amount of aggregate reimbursements paid by the Fund shall in no ev ent exceed the total amount of monies in the Fund as of close of business on June 30 of the applicable fiscal year.

Notes

Ariz. Admin. Code § R20-5-1402

Adopted by final exempt rulemaking at 27 A.A.R. 2920, effective 1/1/2022.