Arizona 2023 2023 Regular Session

Arizona Senate Bill SB1603 Comm Sub / Analysis

Filed 03/02/2023

                      	SB 1603 
Initials AG 	Page 1 	Health & Human Services 
 
ARIZONA HOUSE OF REPRESENTATIVES 
Fifty-sixth Legislature 
First Regular Session 
Senate: HHS DP 4-3-0-0 | 3
rd
 Read 18-11-1-0 
 
SB 1603: hospital; price transparency 
Sponsor: Senator Shamp, LD 29 
Committee on Health & Human Services 
Overview 
Directs licensed hospitals to comply with federal hospital price transparency regulations and 
demonstrate its compliance to the Arizona Department of Health Services (DHS). Subjects 
noncompliant hospitals to a civil penalty.  
History 
45 C.F.R. Part 180 requires hospitals operating within the U.S. to annually establish, update and 
make public a list of hospital's standard changes for items and services provided by the hospital, 
including for diagnosis-related groups (DRG). The Center for Medicare and Medicaid Services 
(CMS) assesses whether a hospital has complied with these requirements. Methods used to 
monitor and evaluate hospital compliance with these regulations include but are not limited to the 
following: 1) evaluation of complaints made by individuals or entities to CMS; 2) CMS review of 
individuals' or entities' analysis of noncompliance; and 3) CMS audit of hospitals' websites.   
If CMS concludes that the hospital is noncompliant with one or more requirements it may take 
any of the following actions: 1) provide a written warning notice to the hospital of the specific 
violations; 2) request a corrective action plan from the hospital if its noncompliance constitutes a 
material violation of one or more requirements; and 3) impose a civil monetary penalty on the 
hospital and publicize the penalty on a CMS website if the hospital fails to respond to its request 
to submit a corrective action plan or comply with the corrective action plan. 
Additionally, health care facilities with more than 50 inpatient beds must make available on 
request or online the direct pay price for at least the 50 most used DRG codes and outpatient 
service codes, if applicable. For health care facilities with 50 or fewer inpatient beds, they must 
make available on request or online the direct pay price for at least the 35 most used DRG codes 
and outpatient services codes, if applicable. The Arizona State Hospital and the Indian Health 
Service hospitals and facilities are excluded from these requirements (A.R.S. § 36-437). 
Currently, the DHS Director can assess a civil penalty against a person who violates statutes or 
rules related to health care institutions in an amount not exceeding $500 for each violation. Each 
day that a violation occurs constitutes a separate violation. Statute outlines the factors the DHS 
Director must consider when determining the civil penalty (A.R.S. § 36-431.01). 
Provisions 
1. Requires hospitals to comply with federal hospital price transparency regulations. (Sec. 1) 
2. Requires hospitals to annually demonstrate to DHS its compliance with federal hospital price 
transparency regulations in a manner prescribed by DHS. (Sec. 1) 
3. Specifies that any hospital that does not comply with the federal hospital price transparency 
regulations is subject to a civil penalty. (Sec. 1) 
☐ Prop 105 (45 votes)     ☐ Prop 108 (40 votes)      ☐ Emergency (40 votes) ☐ Fiscal Note    	SB 1603 
Initials AG 	Page 2 	Health & Human Services 
4. Requires, by January 1, 2025, and annually thereafter, DHS to post a report on its public 
website containing each hospital's level of compliance with the federal hospital transparency 
regulations. (Sec. 1) 
5. Makes technical and conforming changes. (Sec. 1, 2)