Ariz. Admin. Code § R9-15-105 - Verification of Services and Disbursement of Loan Repayment Funds

A. An awardee shall submit, within 10 business days after the last day of a completed calendar quarter, verification and documentation of service hours worked and, if applicable, encounters provided during the calendar quarter at the provider's approved service site, in a Department-provided format, containing:

1. The awardee's name;

2. The beginning and ending dates during which the services were provided;

3. Whether the awardee is providing services full-time or, if applicable, half-time;

4. If applicable, the number of total encounters the awardee provided during the time reported in subsection (A)(2);

5. If services are provided by means of telemedicine, the number of telemedicine hours worked;

6. The awardee's notarized signature and date of signature; and

7. The notarized signature and date of signature of the designee of the awardee's approved service site's governing authority.

B. Upon receipt of the verification and documentation in subsection (A), the Department shall disburse loan payment funds to the awardee's lender or lenders.

C. Services performed before the effective date of a loan repayment contract do not satisfy the contracted health professional service obligation and are not eligible for loan repayment funds.

D. The Department shall disburse loan repayment funds for services provided during a loan repayment contract period according to the allocations in R9-15-208 or R9-15-307, as applicable.

E. The Department may delay disbursing loan repayment funds to an awardee's lender or lenders if the awardee fails to submit service verification and documentation forms as specified in subsection (A).

F. The Department shall not disburse loan repayment funds to an awardee's lender or lenders if the awardee fails to submit complete and accurate information required in subsection (A).

Notes

Ariz. Admin. Code § R9-15-105

Adopted effective November 16, 1983 (Supp. 83-6). Repealed under an exemption from A.R.S. Title 41, Chapter 6, pursuant to Laws 1992, Ch. 301, §61 effective October 1, 1992, filed October 14, 1992 (Supp. 92-4). Adopted by emergency rulemaking at 28 A.A.R. 3684, effective 11/15/2022. Amended by emergency rulemaking at 29 A.A.R. 1274, effective 5/14/2023. New Section made by final rulemaking at 29 A.A.R. 3837, effective 12/6/2023.