Senate Engrossed health care; costs; reimbursement State of Arizona Senate Fifty-sixth Legislature Second Regular Session 2024 SENATE BILL 1402 An Act amending title 20, chapter 1, article 1, Arizona Revised Statutes, by adding section 20-111; relating to health care services. (TEXT OF BILL BEGINS ON NEXT PAGE)
Senate Engrossed health care; costs; reimbursement
State of Arizona Senate Fifty-sixth Legislature Second Regular Session 2024
SENATE BILL 1402
Senate Engrossed
health care; costs; reimbursement
State of Arizona
Senate
Fifty-sixth Legislature
Second Regular Session
2024
SENATE BILL 1402
An Act
amending title 20, chapter 1, article 1, Arizona Revised Statutes, by adding section 20-111; relating to health care services.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona: Section 1. Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding section 20-111, to read: START_STATUTE20-111. Health insurers; savings incentive programs; definitions A. a health insurer may establish a program that provides a savings incentive for enrollees for medically necessary covered health care services that health care providers and health care facilities provide at a price that is below the health insurer's usual reimbursement. B. the program may enable an eligible enrollee who receives covered health care services from a health care provider or health care facility at a price below the health insurer's usual reimbursement to have the amount the enrollee pays applied toward the enrollee's deductible and out-of-pocket maximum and be reimbursed for a portion of the amount of the difference between the price the enrollee paid and the health insurer's usual reimbursement. C. For the purposes of this section: 1. "Health care facility" means a hospital, outpatient surgical center, health care laboratory, diagnostic imaging center or urgent care center. 2. "Health care provider" has the same meaning prescribed in section 32-3216. 3. "Health insurer" has the same meaning prescribed in section 32-3216. 4. "USUAL REIMBURSEMENT" MEANS THE AMOUNT THE HEALTH INSURER WOULD ORDINARILY PAY AN IN-NETWORK HEALTH CARE PROVIDER OR AN IN-NETWORK HEALTH CARE FACILITY FOR THE SERVICE. END_STATUTE
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding section 20-111, to read:
START_STATUTE20-111. Health insurers; savings incentive programs; definitions
A. a health insurer may establish a program that provides a savings incentive for enrollees for medically necessary covered health care services that health care providers and health care facilities provide at a price that is below the health insurer's usual reimbursement.
B. the program may enable an eligible enrollee who receives covered health care services from a health care provider or health care facility at a price below the health insurer's usual reimbursement to have the amount the enrollee pays applied toward the enrollee's deductible and out-of-pocket maximum and be reimbursed for a portion of the amount of the difference between the price the enrollee paid and the health insurer's usual reimbursement.
C. For the purposes of this section:
1. "Health care facility" means a hospital, outpatient surgical center, health care laboratory, diagnostic imaging center or urgent care center.
2. "Health care provider" has the same meaning prescribed in section 32-3216.
3. "Health insurer" has the same meaning prescribed in section 32-3216.
4. "USUAL REIMBURSEMENT" MEANS THE AMOUNT THE HEALTH INSURER WOULD ORDINARILY PAY AN IN-NETWORK HEALTH CARE PROVIDER OR AN IN-NETWORK HEALTH CARE FACILITY FOR THE SERVICE. END_STATUTE