|
HSD Contact: |
Fabian Valle, Program Manager or Tanja M. James, Program Specialist
(Contact Us)
(Fact Sheet)
|
| Purpose: |
To provide an incentive for primary care providers and dentists to provide
primary care services in a rural private practice located in an
AzMUA
(Arizona Medically Underserved Area). Program funds are used to repay qualifying
educational loans in return for primary care service provision. |
| Eligibility: |
Arizona licensed and/or certified:
- Physicians (allopathic
or osteopathic)
- Dentists
- Physician assistants
- Nurse practitioners
- Nurse
mid-wives
(Family or
General Practice, OB/GYN, Pediatrics, or Internal Medicine
are required primary care specialties)
|
| Requirements: |
- Must be a United States citizen
- Have a valid offer of employment at an eligible service
site
- Contract with the State of Arizona to serve full-time for a minimum of
two years
- Provide primary care services at the approved service site
- Be appropriately
licensed and/or certified
- Have no other unfulfilled obligations
|
|
Service
Sites: |
- Provide primary care services in
a rural private practice
- Be located in an
AzMUA
- Accept AHCCCS and Medicare assignments
- Charge for services at the usual
and customary rates prevailing in the primary care area
- Have a
sliding-discount-to-fee scale in place
- Notify consumers of the
availability of the sliding-discount-to-fee scale to eligible individuals
Sliding discount-to-fee schedules must be based
on current Federal Poverty
Guidelines and adhere to
A.A.C. R9-1-504 sliding fee schedule submission and content.
Locating eligible employment is the responsibility of the physician. The
following organizations frequently list employment opportunities. The provider
should confirm site program eligibility before entering into agreements if they
wish to be considered for the program.
Vanessa Sherrill, Physician Recruiter
Arizona Association of Community Health Centers
3R Net
For a list of sites that offer a sliding discount-to-fee scale and
may be eligible for these programs, refer to our
Sliding Fee Scale Clinics
web page. Please
contact this office to determine if a site is eligible.
|
| Award
Amounts: |
Varies
based upon type of provider and priority ranking of the service site.
The priority ranking is determined by such variables as geographic
location and need, etc. The award is in addition to the compensation
package offered by the employer. Award ranges are as follows: |
| |
|
| |
Actual award amounts may differ from the above guidelines dependent on the availability of funds
and outstanding loan balances.
|
Application
Deadlines:
|
Quarterly:
March 15, June 15, September 15, December 15 |
|
Forms:
|
For your
convenience, see list of electronic forms below:
-
Completed applications must be mailed.
- Only applications with original signatures will be
accepted.
- Electronic
or faxed submissions will not be accepted.
The
following links are in PDF format. To download,
Acrobat
Reader™ is required.
The
following forms are for use by contracted Loan Repayment Program
providers. These forms are based contract start dates and must be
submitted to ADHS quarterly with the appropriate
original signatures in order to process Loan Repayment Program payments.
Obligated
service begins on the date indicated on the contract. Service prior to the
start date does not count toward the service obligation. Loan repayments are
made directly to the lender(s) indicated by the provider. Payments are
generated quarterly by the submission of the service verification and
encounter reports immediately following the completion of obligated service.
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