| 65 | | - | Be it enacted by the Legislature of the State of Arizona: Section 1. Title 36, chapter 34, Arizona Revised Statutes, is amended by adding article 4, to read: ARTICLE 4. COLLABORATIVE CARE START_STATUTE36-3451. Definitions In this article, unless the context otherwise requires: 1. "Collaborative care model" means the evidence-based, integrated behavioral health service delivery method that is described as the psychiatric collaborative care model in 81 federal register 80230, that includes a formal collaborative arrangement among a primary care team consisting of a primary care physician, a care manager and a psychiatric consultant and that includes the following elements: (a) Care directed by the primary care team. (b) Structured care management. (c) Regular assessments of clinical status using developmentally appropriate, validated tools. (d) Modification of treatment as appropriate. 2. "Collaborative care technical assistance center": (a) Means a health care organization that can provide educational support and technical assistance related to the collaborative care model. (b) Includes an academic medical center. 3. "Department" means the department of health services. 4. "Primary care physician" has the same meaning prescribed in section 36-2901.END_STATUTE START_STATUTE36-3452. Collaborative care uptake fund; administration; primary care physician grants A. The collaborative care uptake fund is established in the department. The fund consists of monies appropriated by the legislature. Monies in the fund are subject to legislative appropriation and do not revert to the state general fund. B. The department shall use the collaborative care uptake fund monies to make grants to primary care physicians who are in a medical practice with not more than fifty employees to meet the initial costs of establishing and delivering behavioral health integration services through the collaborative care model and for technical assistance grants pursuant to section 36-3453. C. A primary care physician that receives a grant under this section may use the grant monies: 1. To hire staff. 2. To identify and formalize contractual relationships with other health care practitioners, including health care practitioners who will function as psychiatric consultants and behavioral health care managers in providing behavioral health integration services through the collaborative care model. 3. To purchase or upgrade software and other resources needed to appropriately provide behavioral health integration services through the collaborative care model, including resources needed to establish a patient registry and implement measurement-based care. 4. For any other purposes the department prescribes as necessary to support the collaborative care model. END_STATUTE START_STATUTE36-3453. Collaborative care technical assistance center grants; purposes A. The department shall solicit proposals from and enter into grant agreements with eligible collaborative care technical assistance center applicants to provide technical assistance to primary care physicians on providing behavioral health integration services through the collaborative care model. Each collaborative care technical assistance center applicant must provide in the grant application information on how the collaborative care technical assistance center will meet the assistance requirements prescribed in subsection B of this section in order to be eligible for a grant. B. A collaborative care technical assistance center that receives a grant under this section shall provide technical assistance to primary care physicians and shall assist the primary care physicians with the following: 1. Developing financial models and budgets for program launch and sustainability based on practice size. 2. Developing staffing models for essential staff roles, including care managers and consulting psychiatrists. 3. Providing information technology expertise to assist with building the model requirements into electronic health records, including assistance with care manager tools, patient registry, ongoing patient monitoring and patient records. 4. Providing training support for all key staff and operational consultation to develop practice workflows. 5. Establishing methods to ensure the sharing of best practices and operational knowledge among primary care physicians who provide behavioral health integration services through the collaborative care model. 6. For any other purposes the department prescribes as necessary to support the collaborative care model. END_STATUTE Sec. 2. Appropriation; collaborative care uptake fund; exemption A. The sum of $1,000,000 is appropriated from the state general fund in fiscal year 2023-2024 to the collaborative care uptake fund established by section 36-3452, Arizona Revised Statutes, as added by this act, and is appropriated from the collaborative care uptake fund to the department of health services. B. The appropriation made in subsection A of this section is exempt from the provisions of section 35-190, Arizona Revised Statutes, relating to lapsing of appropriations. |
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| 78 | + | Be it enacted by the Legislature of the State of Arizona: Section 1. Section 20-2322, Arizona Revised Statutes, is amended to read: START_STATUTE20-2322. Mental health services and benefits; definitions A. Beginning on January 1, 1998, Any health benefits plan that is offered by an accountable health plan and that provides services or health benefits that include mental health services or mental health benefits shall comply with this section. B. If the health benefits plan does not include an aggregate lifetime limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall not impose any aggregate lifetime limit on mental health services or mental health benefits. If the health benefits plan includes an aggregate lifetime limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall either: 1. Apply the applicable lifetime limit to both the health services or health benefits that are not related to mental health services or mental health benefits and to the mental health services or mental health benefits. 2. Not include an aggregate lifetime limit on mental health services or mental health benefits that is less than the applicable lifetime limit for health services or health benefits that are not related to mental health services or mental health benefits. C. If the health benefits plan does not include an aggregate annual limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall not impose any aggregate annual limit on mental health services or mental health benefits. If the health benefits plan includes an aggregate annual limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall either: 1. Apply the applicable annual limit to both the health services or health benefits that are not related to mental health services or mental health benefits and to the mental health services or mental health benefits. 2. Not include any aggregate annual limit on mental health services or mental health benefits that is less than the applicable annual limit for health services or health benefits that are not related to mental health services or mental health benefits. D. Except as provided in subsections A, B and C, this section does not prevent an accountable health plan that offers a health benefits plan that provides mental health services or mental health benefits from imposing terms and conditions, including cost sharing, limits on the number of visits or days of coverage or requirements relating to medical necessity in relation to the amount, duration or scope of coverage for mental health services or mental health benefits under the health benefits plan. Nothing in This section requires does not require an accountable health plan to: 1. Offer a health benefits plan that provides mental health services or mental health benefits. 2. Comply with this section in connection with any health benefits plan offered to a small employer. 3. 2. Comply with this section if that compliance under the health benefits plan offered by the accountable health plan would result in an increase in the cost to the health benefits plan of at least one per cent percent. E. The requirements of this section apply separately to each health benefits plan offered by an accountable health plan and shall be consistent with title VII of the health insurance portability and accountability act of 1996 (P.L. 104-204; 110 Stat. 2944) and 45 Code of Federal Regulations part 146. F. An entity that offers, issues or otherwise provides an individual or group health benefits plan that provides mental health services or mental health benefits shall provide reimbursement for the services or benefits that are delivered through the psychiatric collaborative care model, which shall include the following current procedural terminology billing codes established by the American medical association as of the effective date of this amendment to this section: 1. 99492. 2. 99493. 3. 99494. G. The director shall adopt rules to update the current procedural terminology billing codes listed in subsection F of this section if there are any alterations or additions to the billing codes for the psychiatric collaborative care model. H. An entity that offers, issues or otherwise provides an individual or group health benefits plan that provides mental health services or mental health benefits may deny reimbursement of any current procedural terminology billing code listed in subsection F of this section on the grounds of medical necessity if the medical necessity determination: 1. Complies with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (P.L. 110-33) and its implementing regulations. 2. Accords with the utilization review requirements established under Chapter 15 of this Title. F. I. Mental health services or mental health benefits do not include benefits for the treatment of substance abuse or chemical dependency. G. J. For the purposes of this section: 1. "Aggregate annual limit" means a dollar limitation on the total amount that may be paid in a twelve month period for benefits or services under a health benefits plan for an individual who is covered under a health benefits plan. 2. "Aggregate lifetime limit" means a dollar limitation on the total amount that may be paid for benefits or services under a health benefits plan for an individual who is covered under a health benefits plan. 3. "Psychiatric Collaborative Care Model" means the evidence-based, integrated behavioral health service delivery method published in the Federal Register, volume 81, number 220, November 15, 2016, page 80230. END_STATUTE |
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