AZ HB2823

Adds new "certificate of operation" pathway for ambulance services providing interfacility transfers (non-911 patient transport between health care institutions within a hospital system), separate from the existing "certificate of necessity" requirement for general ambulance services.

Certificate of operation applicants must be accredited by the Commission on Accreditation of Ambulance Services in another state, obtain hospital system sponsorship, contract with a third-party vendor to report performance data, and file appropriate bonds and fees.

Initial certificate of operation valid for three years; director may evaluate performance after one year and require improvement plans for substandard performance; renewal requires continued accreditation and meeting director requirements.

Certificate of operation becomes void if hospital system sponsorship is terminated; public hearings and judicial review do not apply to certificates of operation.

Adds new definitions including "hospital system," "interfacility transfer," and "sponsoring hospital system" to Arizona's emergency medical services regulatory framework.