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| 52 | 53 | | An Act |
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| 56 | 57 | | amending title 20, chapter 1, article 1, Arizona Revised Statutes, by adding section 20-111; relating to health care services. |
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| 62 | 63 | | (TEXT OF BILL BEGINS ON NEXT PAGE) |
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| 66 | 67 | | 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 |
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| 68 | 69 | | Be it enacted by the Legislature of the State of Arizona: |
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| 70 | 71 | | Section 1. Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding section 20-111, to read: |
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| 71 | 72 | | |
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| 72 | 73 | | START_STATUTE20-111. Health insurers; savings incentive programs; definitions |
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| 73 | 74 | | |
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| 74 | 75 | | 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. |
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| 75 | 76 | | |
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| 76 | 77 | | 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. |
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| 77 | 78 | | |
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| 78 | 79 | | C. For the purposes of this section: |
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| 79 | 80 | | |
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| 80 | 81 | | 1. "Health care facility" means a hospital, outpatient surgical center, health care laboratory, diagnostic imaging center or urgent care center. |
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| 82 | 83 | | 2. "Health care provider" has the same meaning prescribed in section 32-3216. |
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| 83 | 84 | | |
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| 84 | 85 | | 3. "Health insurer" has the same meaning prescribed in section 32-3216. |
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| 85 | 86 | | |
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| 86 | 87 | | 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 |
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