Fiscal Note
BILL # HB 2453 TITLE: AHCCCS; naturopathic physicians
SPONSOR: Montenegro STATUS: As Introduced
PREPARED BY: Maggie Rocker
Description
The bill would modify the definition of primary care practitioner to include naturopathic physicians for the purposes of
AHCCCS coverage.
Estimated Impact
We estimate that the bill's provisions would increase General Fund costs by $100,000 and Total Funds costs by $500,000
annually. This estimate is based on an actuarial analysis provided by AHCCCS.
Analysis
AHCCCS contractors are required by statute to cover inpatient and outpatient health services provided by or under the
direction of a physician or a primary care practitioner. The proposed legislation would expand the definition of primary
care practitioner to include naturopathic physicians. Statute defines the practice of naturopathic medicine as a medical
system of diagnosing and treating diseases, injuries, ailments, infirmities and other conditions of the human mind and
body including by natural means, drugless methods, drugs, non-surgical methods, devices, physical, electrical, hygienic,
and sanitary measures and all forms of physical agents and modalities.
The change would not become effective unless AHCCCS obtains approval from the Centers for Medicare and Medicaid
Services by October 1, 2027.
AHCCCS's analysis assumes that most naturopathic doctor (ND) office visits would represent a cost neutral shift from visits
to doctors of medicine (MD) and doctors of osteopathic medicine (DO). However, AHCCCS believes a cost would be
generated based on the number of duplicative follow-up visits to an MD/DO for a prescription.
AHCCCS's estimate assumes that 27 NDs would secure a managed care contract, and that 33.2% of the ND patient panel
(or ~19,000 members) would be Medicaid enrollees, each visiting an ND twice per year. AHCCCS projects that of the
38,000 ND visits, 20% of visits would require a follow-up visit to an MD or DO for a prescription. Using the current fee-for-
service rate for office outpatient visits ($62.93), this would result in an annual cost of $100,000 General Fund/$500,000
Total Funds.
Local Government Impact
None
2/13/24