A. The applicant or any certificate of necessity holder whose ambulance service area in whole or in part is within the affected service area of the initial or amended certificate of necessity may appeal pursuant to Title 41, Chapter 6, Article 10 the director‘s determination within thirty days after the decision. If an appeal is made, the director shall require a public hearing be held within one hundred twenty days after the hearing notice is issued on the director’s determination on the initial or amended certificate of necessity.

B. For the purposes of any hearing held pursuant to this section, a city, town, fire district, fire authority or tribal government whose jurisdictional boundaries in whole or in part are within the service area of a certificate of necessity, an existing certificate of necessity holder within the service area of the certificate of necessity or a hospital that is licensed pursuant to chapter 4 of this title and that is located within the service area of a certificate of necessity is considered to be an interested party as a matter of law.

C. The director shall require a public hearing on any proposed action relating to an adjustment of general public rates, charges or certificate of necessity transfers unless subsection E, G or O of this section applies.

D. An appeal pursuant to subsection A of this section or a public hearing held pursuant to subsection C of this section shall meet the following requirements:

1. The hearing shall be held pursuant to Title 41, Chapter 6, Article 10, except as specifically provided in this section.

2. The director shall mail notice of the hearing to every ambulance service in the affected region and every interested party as specified in subsection B of this section not later than fifteen days before the hearing.

3. The director may mail notice to other persons who the director determines are interested in the hearing.

4. In a hearing or rehearing conducted pursuant to this article, an ambulance service may be represented by a corporate officer, an employee or a designee who has been specifically authorized by the ambulance service to represent it.

5. A certificate of necessity appeal hearing may not last more than five consecutive business days unless the administrative law judge determines, in writing, on the final day of the hearing that there is an extraordinary need for additional hearing days. The administrative law judge in that case may add up to five additional consecutive business days for the hearing. The additional hearing days shall be calendared within thirty days after the end of the initial hearing.

6. The administrative law judge of the office of administrative hearings shall issue a written decision within twenty days after the hearing is concluded. The written decision shall contain a concise explanation of the reasons supporting the decision, including the findings of fact and conclusions of law. The administrative law judge shall serve a copy of the decision on the department and all parties to the action. On request of the department, the office of administrative hearings shall also transmit to the department the record of the hearing as described in section 12-904. A copy of the administrative law judge’s decision is deemed sent on personal delivery of the decision or five days after the decision is mailed to the director.

7. Within thirty days after the date the office of administrative hearings sends a copy of the administrative law judge’s decision to the department, the director shall review the decision and accept, reject or modify the decision. If the director rejects or modifies the decision, the director must file with the office of administrative hearings and serve on all parties a copy of the administrative law judge’s decision with the director’s rejection or modification and a written justification setting forth the reasons for the rejection or modification of each finding of fact or conclusion of law. If there is a rejection or modification of a conclusion of law, the written justification shall be sent to the president of the senate and the speaker of the house of representatives.

8. If the director does not accept, reject or modify the administrative law judge’s decision within thirty days after the date the office of administrative hearings sends a copy of the administrative law judge’s decision to the director, as evidenced by receipt of such action by the office of administrative hearings on or before the thirtieth day, the office of administrative hearings shall certify the administrative law judge’s decision as the final administrative decision.

9. The decision entered as specifically provided by this subsection is the final administrative decision.

E. The director may waive the hearing required under subsection C of this section if notification, including a general description of the proposed action of the department and the time and manner for any interested person to request a hearing, is given and all of the following apply:

1. Notification of the proposed action has been sent to every ambulance service in the affected region not later than fifteen days before the action.

2. The director has notified other persons who the director determines are interested in the proposed action not later than fifteen days before the action.

3. The director has published notice of the proposed action in a newspaper of general circulation in the affected region at least once each week for two consecutive weeks before the action is taken.

4. The director has received no requests within the fifteen-day notification period for a hearing to be held on the proposed action.

F. If the director receives a request pursuant to subsection E, paragraph 4 of this section, the director shall hold a hearing in compliance with subsection D of this section.

G. The director shall not hold a hearing if a person requests a hearing regarding a rate increase that does not exceed the amount computed as follows:

1. Determine the percentage growth in the transportation consumer price index of the United States department of labor, bureau of labor statistics, from the end of the second preceding calendar year to the calendar year immediately preceding the calendar year for which the rate increase is requested.

2. Determine the percentage growth in the medical care consumer price index of the United States department of labor, bureau of labor statistics, from the end of the second preceding calendar year to the calendar year immediately preceding the calendar year for which the rate increase is requested.

3. Add the amount determined in paragraph 1 of this subsection to the amount determined in paragraph 2 of this subsection and divide the sum by two.

H. A rate increase authorized pursuant to subsection G of this section is deemed to be fixed by the department at the requested level. Notwithstanding subsection E of this section, the department shall hold a hearing pursuant to section 36-2232, subsection E for any proposed uniform rate or charge that exceeds the annual rate increase prescribed in subsection G of this section. The department shall require the applicants to submit the following information signed by the designated financial officer and the chief executive of the ambulance service who has fiduciary responsibility for providing accurate financial information:

1. A financial statement for the previous twenty-four months relating to the certificated areas.

2. Any additional information the department requires to analyze the request.

I. If an ambulance service with an established general public rate applies for a contract rate or range of rates that is up to thirty percent less than its established rate, the director shall grant the rate without a public hearing or waiver, and without any right of intervention, unless within ninety days after the filing of a completed application the director determines that the contract rate or range of rates applied for does not accurately reflect the cost and economics of providing the contract services, would adversely affect the service available to the general public in the area of service as designated by its certificate of necessity or would cause any fixed rate, fare or charge to the general public to be adversely affected.

J. If the department disallows a proposed contract rate pursuant to subsection I of this section, the ambulance service has a right to a hearing for review of the proposed contract rate or range of rates.

K. The director may adopt rules for the establishment of a contract rate or range of rates that may be implemented and that exceeds the thirty percent rate variance identified pursuant to subsection I of this section.

L. Subsections I, J and K of this section are limited to contract rates or a range of rates applied for prescheduled, interfacility or convalescent transports.

M. A service contract between an ambulance service and a political subdivision of this state, including local fire districts, shall be filed with and approved by the department in accordance with the following requirements:

1. On receipt of the proposed contract, the department has fifteen days to review the contract and notify the ambulance service of any additional information the department requires, recommended corrections or any provision that does or may violate this article.

2. The ambulance service has fifteen days to provide the department with the information requested or to submit a revised or amended contract if required under paragraph 1 of this subsection.

3. The contract becomes effective fifteen days after the ambulance service complies with the department’s request unless the department determines that any rate or charge or other provisions specified in the contract will cause any fixed rate or charge to the general public rate to be adversely affected or the contract would be in violation of the ambulance service’s certificate of necessity.

4. If the department disallows a proposed contract pursuant to this subsection, the ambulance service has a right to a hearing for review of the proposed contract.

5. The rates and charges contained in the contract are the rates and charges fixed by the director in a decision or order for the ambulance service and conform to the ambulance service’s current or subsequent general public rates and charges.

6. The area of response is within the ambulance service’s certificated area.

N. In case of emergency, the director may take action providing for immediate suspension of a certificate of registration or a certificate of necessity, or both, under this section without notice or a hearing if the director determines that a potential threat to the public health and safety exists. If such an action is taken by the director, the director shall conduct a hearing within ten days after the date of the director’s action unless the person against whom the action is directed waives the right to have a hearing held within ten days. If the ten-day hearing requirement is waived, the director shall set a date mutually agreeable to the interested parties. The purpose of the hearing is to review the decision of the director to take such an action. The director shall make findings of fact and may continue, suspend or modify the director’s action.

O. The director shall waive the hearing required under subsection C of this section if geographic changes in suboperation stations do not alter the service area or adversely affect approved response times.

P. Except as provided in Section 41-1092.08, subsection H, a final decision of the director relating to an adjustment of general public rates, charges or certificate of necessity transfers is subject to judicial review pursuant to Title 12, Chapter 7, Article 6.

Q. The final administrative decision of the director or the administrative law judge as prescribed in subsection D of this section for an initial or amended certificate of necessity is subject to judicial review pursuant to Title 12, Chapter 7, Article 6.

R. For the purposes of this section, "hearing day":

1. Means any portion of a business day that is used for any hearing-related activity, including testimony, argument or presentation of evidence.

2. Does not include prehearing conferences or other administrative matters that occur before the start of the hearing.