Senate Engrossed health care; costs; reimbursement State of Arizona Senate Fifty-sixth Legislature Second Regular Session 2024 CHAPTER 184 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
CHAPTER 184
SENATE BILL 1402
Senate Engrossed
health care; costs; reimbursement
State of Arizona
Senate
Fifty-sixth Legislature
Second Regular Session
2024
CHAPTER 184
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
APPROVED BY THE GOVERNOR MAY 6, 2024. FILED IN THE OFFICE OF THE SECRETARY OF STATE MAY 6, 2024.
APPROVED BY THE GOVERNOR MAY 6, 2024.
FILED IN THE OFFICE OF THE SECRETARY OF STATE MAY 6, 2024.