Arizona 2023 Regular Session

Arizona Senate Bill SB1158 Compare Versions

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Version 2 (New)

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1		-	~~Senate Engrossed~~ AHCCCS; naturopathic physicians State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023 ~~SENATE BILL~~ 1158 An Act amending section 36-2901, Arizona Revised Statutes, as amended by Laws 2015, chapter 195, section 56; amending section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2; relating to the Arizona health care cost containment system. (TEXT OF BILL BEGINS ON NEXT PAGE)
	1	+	REFERENCE TITLE: AHCCCS; naturopathic physicians State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023 SB 1158 Introduced by Senator Shope An Act amending section 36-2901, Arizona Revised Statutes, as amended by Laws 2015, chapter 195, section 56; amending section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2; relating to the Arizona health care cost containment system. (TEXT OF BILL BEGINS ON NEXT PAGE)
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9		-	~~Senate Engrossed~~ AHCCCS; naturopathic physicians
	9	+	REFERENCE TITLE: AHCCCS; naturopathic physicians
10	10		State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023
11		-	SENATE BILL 1158
	11	+	SB 1158
	12	+	Introduced by Senator Shope
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17		-	AHCCCS; naturopathic physicians
	14	+	REFERENCE TITLE: AHCCCS; naturopathic physicians
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51	64		An Act
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55	68		amending section 36-2901, Arizona Revised Statutes, as amended by Laws 2015, chapter 195, section 56; amending section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2; relating to the Arizona health care cost containment system.
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65	78		Be it enacted by the Legislature of the State of Arizona: Section 1. Section 36-2901, Arizona Revised Statutes, as amended by Laws 2015, chapter 195, section 56, is amended to read: START_STATUTE36-2901. Definitions In this article, unless the context otherwise requires: 1. "Administration" means the Arizona health care cost containment system administration. 2. "Administrator" means the administrator of the Arizona health care cost containment system. 3. "Contractor" means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers. 4. "Department" means the department of economic security. 5. "Director" means the director of the Arizona health care cost containment system administration. 6. "Eligible person" means any person who is: (a) Any of the following: (i) Defined as mandatorily or optionally eligible pursuant to title XIX of the social security act as authorized by the state plan. (ii) Defined in title XIX of the social security act as an eligible pregnant woman with a family income that does not exceed one hundred fifty percent of the federal poverty guidelines, as a child under the age of six years and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines or as children who have not attained nineteen years of age and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines. (iii) Under twenty-six years of age and who was in the custody of the department of child safety pursuant to title 8, chapter 4 when the person became eighteen years of age. (iv) Defined as eligible pursuant to section 36-2901.01. (v) Defined as eligible pursuant to section 36-2901.04. (vi) Defined as eligible pursuant to section 36-2901.07. (b) A full-time officer or employee of this state or of a city, town or school district of this state or other person who is eligible for hospitalization and medical care under title 38, chapter 4, article 4. (c) A full-time officer or employee of any county in this state or other persons authorized by the county to participate in county medical care and hospitalization programs if the county in which such officer or employee is employed has authorized participation in the system by resolution of the county board of supervisors. (d) An employee of a business within this state. (e) A dependent of an officer or employee who is participating in the system. (f) Not enrolled in the Arizona long-term care system pursuant to article 2 of this chapter. (g) Defined as eligible pursuant to section 1902(a)(10)(A)(ii)(XV) and (XVI) of title XIX of the social security act and who meets the income requirements of section 36-2929. 7. "Graduate medical education" means a program, including an approved fellowship, that prepares a physician for the independent practice of medicine by providing didactic and clinical education in a medical discipline to a medical student who has completed a recognized undergraduate medical education program. 8. "Malice" means evil intent and outrageous, oppressive or intolerable conduct that creates a substantial risk of tremendous harm to others. 9. "Member" means an eligible person who enrolls in the system. 10. "Modified adjusted gross income" has the same meaning prescribed in 42 United States Code section 1396a(e)(14). 11. "Noncontracting provider" means a person who provides health care to members pursuant to this article but not pursuant to a subcontract with a contractor. 12. "Physician" means a person who is licensed pursuant to title 32, chapter 13, 14 or 17. 13. "Prepaid capitated" means a mode of payment by which a health care contractor directly delivers health care services for the duration of a contract to a maximum specified number of members based on a fixed rate per member notwithstanding: (a) The actual number of members who receive care from the contractor. (b) The amount of health care services provided to any member. 14. "Primary care physician" means a physician who is a family practitioner, general practitioner, pediatrician, general internist, or obstetrician or gynecologist. 15. "Primary care practitioner" means a nurse practitioner who is certified pursuant to title 32, chapter 15 or a physician assistant certified who is licensed pursuant to title 32, chapter 25. This paragraph does not expand the scope of practice for nurse practitioners as defined pursuant to title 32, chapter 15, or for physician assistants as defined pursuant to title 32, chapter 25. 16. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401. 17. "Section 1115 waiver" means the research and demonstration waiver granted by the United States department of health and human services. 18. "Special health care district" means a special health care district organized pursuant to title 48, chapter 31. 19. "State plan" has the same meaning prescribed in section 36-2931. 20. "System" means the Arizona health care cost containment system established by this article. END_STATUTE Sec. 2. Section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2, is amended to read: START_STATUTE36-2901. Definitions In this article, unless the context otherwise requires: 1. "Administration" means the Arizona health care cost containment system administration. 2. "Administrator" means the administrator of the Arizona health care cost containment system. 3. "Contractor" means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers. 4. "Department" means the department of economic security. 5. "Director" means the director of the Arizona health care cost containment system administration. 6. "Eligible person" means any person who is: (a) Any of the following: (i) Defined as mandatorily or optionally eligible pursuant to title XIX of the social security act as authorized by the state plan. (ii) Defined in title XIX of the social security act as an eligible pregnant woman or a woman who is less than one year postpartum with a family income that does not exceed one hundred fifty percent of the federal poverty guidelines, as a child under the age of six years and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines or as children who have not attained nineteen years of age and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines. (iii) Under twenty-six years of age and who was in the custody of the department of child safety pursuant to title 8, chapter 4 when the person became eighteen years of age. (iv) Defined as eligible pursuant to section 36-2901.01. (v) Defined as eligible pursuant to section 36-2901.04. (vi) Defined as eligible pursuant to section 36-2901.07. (b) A full-time officer or employee of this state or of a city, town or school district of this state or other person who is eligible for hospitalization and medical care under title 38, chapter 4, article 4. (c) A full-time officer or employee of any county in this state or other persons authorized by the county to participate in county medical care and hospitalization programs if the county in which such officer or employee is employed has authorized participation in the system by resolution of the county board of supervisors. (d) An employee of a business within this state. (e) A dependent of an officer or employee who is participating in the system. (f) Not enrolled in the Arizona long-term care system pursuant to article 2 of this chapter. (g) Defined as eligible pursuant to section 1902(a)(10)(A)(ii)(XV) and (XVI) of title XIX of the social security act and who meets the income requirements of section 36-2929. 7. "Graduate medical education" means a program, including an approved fellowship, that prepares a physician for the independent practice of medicine by providing didactic and clinical education in a medical discipline to a medical student who has completed a recognized undergraduate medical education program. 8. "Malice" means evil intent and outrageous, oppressive or intolerable conduct that creates a substantial risk of tremendous harm to others. 9. "Member" means an eligible person who enrolls in the system. 10. "Modified adjusted gross income" has the same meaning prescribed in 42 United States Code section 1396a(e)(14). 11. "Noncontracting provider" means a person who provides health care to members pursuant to this article but not pursuant to a subcontract with a contractor. 12. "Physician" means a person who is licensed pursuant to title 32, chapter 13, 14 or 17. 13. "Prepaid capitated" means a mode of payment by which a health care contractor directly delivers health care services for the duration of a contract to a maximum specified number of members based on a fixed rate per member notwithstanding: (a) The actual number of members who receive care from the contractor. (b) The amount of health care services provided to any member. 14. "Primary care physician" means a physician who is a family practitioner, general practitioner, pediatrician, general internist, or obstetrician or gynecologist. 15. "Primary care practitioner" means a nurse practitioner or certified nurse midwife who is certified pursuant to title 32, chapter 15 or a physician assistant who is licensed pursuant to title 32, chapter 25. This paragraph does not expand the scope of practice for nurse practitioners or certified nurse midwives as defined pursuant to title 32, chapter 15 or for physician assistants as defined pursuant to title 32, chapter 25. 16. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401. 17. "Section 1115 waiver" means the research and demonstration waiver granted by the United States department of health and human services. 18. "Special health care district" means a special health care district organized pursuant to title 48, chapter 31. 19. "State plan" has the same meaning prescribed in section 36-2931. 20. "System" means the Arizona health care cost containment system established by this article. END_STATUTE Sec. 3. Conditional enactment; notice A. Section 36-1901, Arizona Revised Statutes, as amended by Laws 2015, chapter 195, section 56 and this act, and section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2 and this act: 1. Do not become effective unless on or before October 1, 2026 the centers for medicare and medicaid services approve doctors of naturopathic medicine as service providers. 2. Becomes effective from and after September 30 of the year following the approval. B. The Arizona health care cost containment system administration shall notify the director of the Arizona legislative council in writing on or before November 1, 2026 either: 1. Of the date of the approval by the centers for medicare and medicaid services. 2. That the centers for medicare and medicaid services did not approve the administration's request. Sec. 4. Conditional enactment Section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2 and this act, becomes effective only on the occurrence of the condition prescribed by Laws 2022, chapter 314, section 27.
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67	80		Be it enacted by the Legislature of the State of Arizona:
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69	82		Section 1. Section 36-2901, Arizona Revised Statutes, as amended by Laws 2015, chapter 195, section 56, is amended to read:
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71	84		START_STATUTE36-2901. Definitions
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73	86		In this article, unless the context otherwise requires:
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75	88		1. "Administration" means the Arizona health care cost containment system administration.
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77	90		2. "Administrator" means the administrator of the Arizona health care cost containment system.
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79	92		3. "Contractor" means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers.
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81	94		4. "Department" means the department of economic security.
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83	96		5. "Director" means the director of the Arizona health care cost containment system administration.
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85	98		6. "Eligible person" means any person who is:
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87	100		(a) Any of the following:
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89	102		(i) Defined as mandatorily or optionally eligible pursuant to title XIX of the social security act as authorized by the state plan.
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91	104		(ii) Defined in title XIX of the social security act as an eligible pregnant woman with a family income that does not exceed one hundred fifty percent of the federal poverty guidelines, as a child under the age of six years and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines or as children who have not attained nineteen years of age and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines.
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93	106		(iii) Under twenty-six years of age and who was in the custody of the department of child safety pursuant to title 8, chapter 4 when the person became eighteen years of age.
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95	108		(iv) Defined as eligible pursuant to section 36-2901.01.
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97	110		(v) Defined as eligible pursuant to section 36-2901.04.
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99	112		(vi) Defined as eligible pursuant to section 36-2901.07.
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101	114		(b) A full-time officer or employee of this state or of a city, town or school district of this state or other person who is eligible for hospitalization and medical care under title 38, chapter 4, article 4.
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103	116		(c) A full-time officer or employee of any county in this state or other persons authorized by the county to participate in county medical care and hospitalization programs if the county in which such officer or employee is employed has authorized participation in the system by resolution of the county board of supervisors.
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105	118		(d) An employee of a business within this state.
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107	120		(e) A dependent of an officer or employee who is participating in the system.
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109	122		(f) Not enrolled in the Arizona long-term care system pursuant to article 2 of this chapter.
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111	124		(g) Defined as eligible pursuant to section 1902(a)(10)(A)(ii)(XV) and (XVI) of title XIX of the social security act and who meets the income requirements of section 36-2929.
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113	126		7. "Graduate medical education" means a program, including an approved fellowship, that prepares a physician for the independent practice of medicine by providing didactic and clinical education in a medical discipline to a medical student who has completed a recognized undergraduate medical education program.
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115	128		8. "Malice" means evil intent and outrageous, oppressive or intolerable conduct that creates a substantial risk of tremendous harm to others.
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117	130		9. "Member" means an eligible person who enrolls in the system.
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119	132		10. "Modified adjusted gross income" has the same meaning prescribed in 42 United States Code section 1396a(e)(14).
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121	134		11. "Noncontracting provider" means a person who provides health care to members pursuant to this article but not pursuant to a subcontract with a contractor.
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123	136		12. "Physician" means a person who is licensed pursuant to title 32, chapter 13, 14 or 17.
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125	138		13. "Prepaid capitated" means a mode of payment by which a health care contractor directly delivers health care services for the duration of a contract to a maximum specified number of members based on a fixed rate per member notwithstanding:
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127	140		(a) The actual number of members who receive care from the contractor.
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129	142		(b) The amount of health care services provided to any member.
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131	144		14. "Primary care physician" means a physician who is a family practitioner, general practitioner, pediatrician, general internist, or obstetrician or gynecologist.
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133	146		15. "Primary care practitioner" means a nurse practitioner who is certified pursuant to title 32, chapter 15 or a physician assistant certified who is licensed pursuant to title 32, chapter 25. This paragraph does not expand the scope of practice for nurse practitioners as defined pursuant to title 32, chapter 15, or for physician assistants as defined pursuant to title 32, chapter 25.
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135	148		16. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401.
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137	150		17. "Section 1115 waiver" means the research and demonstration waiver granted by the United States department of health and human services.
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139	152		18. "Special health care district" means a special health care district organized pursuant to title 48, chapter 31.
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141	154		19. "State plan" has the same meaning prescribed in section 36-2931.
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143	156		20. "System" means the Arizona health care cost containment system established by this article. END_STATUTE
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145	158		Sec. 2. Section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2, is amended to read:
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147	160		START_STATUTE36-2901. Definitions
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149	162		In this article, unless the context otherwise requires:
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151	164		1. "Administration" means the Arizona health care cost containment system administration.
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153	166		2. "Administrator" means the administrator of the Arizona health care cost containment system.
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155	168		3. "Contractor" means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers.
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157	170		4. "Department" means the department of economic security.
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159	172		5. "Director" means the director of the Arizona health care cost containment system administration.
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161	174		6. "Eligible person" means any person who is:
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163	176		(a) Any of the following:
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165	178		(i) Defined as mandatorily or optionally eligible pursuant to title XIX of the social security act as authorized by the state plan.
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167	180		(ii) Defined in title XIX of the social security act as an eligible pregnant woman or a woman who is less than one year postpartum with a family income that does not exceed one hundred fifty percent of the federal poverty guidelines, as a child under the age of six years and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines or as children who have not attained nineteen years of age and whose family income does not exceed one hundred thirty-three percent of the federal poverty guidelines.
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169	182		(iii) Under twenty-six years of age and who was in the custody of the department of child safety pursuant to title 8, chapter 4 when the person became eighteen years of age.
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171	184		(iv) Defined as eligible pursuant to section 36-2901.01.
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173	186		(v) Defined as eligible pursuant to section 36-2901.04.
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175	188		(vi) Defined as eligible pursuant to section 36-2901.07.
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177	190		(b) A full-time officer or employee of this state or of a city, town or school district of this state or other person who is eligible for hospitalization and medical care under title 38, chapter 4, article 4.
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179	192		(c) A full-time officer or employee of any county in this state or other persons authorized by the county to participate in county medical care and hospitalization programs if the county in which such officer or employee is employed has authorized participation in the system by resolution of the county board of supervisors.
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181	194		(d) An employee of a business within this state.
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183	196		(e) A dependent of an officer or employee who is participating in the system.
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185	198		(f) Not enrolled in the Arizona long-term care system pursuant to article 2 of this chapter.
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187	200		(g) Defined as eligible pursuant to section 1902(a)(10)(A)(ii)(XV) and (XVI) of title XIX of the social security act and who meets the income requirements of section 36-2929.
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189	202		7. "Graduate medical education" means a program, including an approved fellowship, that prepares a physician for the independent practice of medicine by providing didactic and clinical education in a medical discipline to a medical student who has completed a recognized undergraduate medical education program.
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191	204		8. "Malice" means evil intent and outrageous, oppressive or intolerable conduct that creates a substantial risk of tremendous harm to others.
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193	206		9. "Member" means an eligible person who enrolls in the system.
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195	208		10. "Modified adjusted gross income" has the same meaning prescribed in 42 United States Code section 1396a(e)(14).
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197	210		11. "Noncontracting provider" means a person who provides health care to members pursuant to this article but not pursuant to a subcontract with a contractor.
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199	212		12. "Physician" means a person who is licensed pursuant to title 32, chapter 13, 14 or 17.
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201	214		13. "Prepaid capitated" means a mode of payment by which a health care contractor directly delivers health care services for the duration of a contract to a maximum specified number of members based on a fixed rate per member notwithstanding:
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203	216		(a) The actual number of members who receive care from the contractor.
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205	218		(b) The amount of health care services provided to any member.
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207	220		14. "Primary care physician" means a physician who is a family practitioner, general practitioner, pediatrician, general internist, or obstetrician or gynecologist.
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209	222		15. "Primary care practitioner" means a nurse practitioner or certified nurse midwife who is certified pursuant to title 32, chapter 15 or a physician assistant who is licensed pursuant to title 32, chapter 25. This paragraph does not expand the scope of practice for nurse practitioners or certified nurse midwives as defined pursuant to title 32, chapter 15 or for physician assistants as defined pursuant to title 32, chapter 25.
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211	224		16. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401.
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213	226		17. "Section 1115 waiver" means the research and demonstration waiver granted by the United States department of health and human services.
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215	228		18. "Special health care district" means a special health care district organized pursuant to title 48, chapter 31.
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217	230		19. "State plan" has the same meaning prescribed in section 36-2931.
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219	232		20. "System" means the Arizona health care cost containment system established by this article. END_STATUTE
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221	234		Sec. 3. Conditional enactment; notice
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223	236		A. Section 36-1901, Arizona Revised Statutes, as amended by Laws 2015, chapter 195, section 56 and this act, and section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2 and this act:
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225	238		1. Do not become effective unless on or before October 1, 2026 the centers for medicare and medicaid services approve doctors of naturopathic medicine as service providers.
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227	240		2. Becomes effective from and after September 30 of the year following the approval.
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229	242		B. The Arizona health care cost containment system administration shall notify the director of the Arizona legislative council in writing on or before November 1, 2026 either:
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231	244		1. Of the date of the approval by the centers for medicare and medicaid services.
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233	246		2. That the centers for medicare and medicaid services did not approve the administration's request.
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235	248		Sec. 4. Conditional enactment
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237	250		Section 36-2901, Arizona Revised Statutes, as amended by Laws 2022, chapter 314, section 2 and this act, becomes effective only on the occurrence of the condition prescribed by Laws 2022, chapter 314, section 27.