Fiscal Note
BILL # HB 2290 TITLE: insurance; claims; appeals; provider credentialing
SPONSOR: Cook STATUS: House Engrossed
PREPARED BY: Nate Belcher
Description
The bill would establish procedures and timeframes for when a health care insurer denies a health care claim. The bill
also expands the ability of providers to appeal a claim if an insurer initially declines it.
Estimated Impact
The Office of Administrative Hearings (OAH) estimates it would incur about $30,000 in annual costs for administering the
provisions of this bill.
Analysis
The bill would establish regulatory procedures and timeframes for when a health care insurer denies a health care
services claim. The Department of Insurance and Financial Institutions (DIFI) would be required to request a hearing with
OAH regarding a claim denial if a provider submits a hearing request to them. OAH estimates that this would generate
about 240 new cases per year, which they have estimated would cost them about $30,000 per year to hear.
These new requirements could also affect the Arizona Department of Administration (ADOA). We have asked ADOA if
they believe the bill will have an impact on its health insurance system for state employees and are awaiting a response.
The Arizona Health Care Cost Containment System would be exempt from the bill's provisions.
Local Government Impact
None
3/22/23