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| 55 | 64 | | AN ACT |
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| 59 | 68 | | Amending title 36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36-2930.07; relating to the Arizona health care cost containment system. |
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| 65 | 74 | | (TEXT OF BILL BEGINS ON NEXT PAGE) |
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| 69 | 78 | | Be it enacted by the Legislature of the State of Arizona: Section 1. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding section 36-2930.07, to read: START_STATUTE36-2930.07. Reimbursement rates; nonemergency medical transportation; study; report A. The Arizona health care cost containment system may receive funding from nonemergency medical transportation providers and other interested enterprises to cover the costs of a nonemergency medical transportation rate reimbursement study. B. if the Arizona health care cost containment system administration receives sufficient monies pursuant to subsection A of this section for a nonemergency medical transportation rate reimbursement study, the administration shall contract with an independent consulting firm for a study of the adequacy and appropriateness of title XIX reimbursement rates to transportation network companies and nonemergency medical transportation brokers for providing medically necessary nonemergency transportation when transporting members to and from a covered physical or behavioral health service pursuant to sections 36-2907 and 36-2989. The study shall review the costs necessary to meet the requirements for the transportation of members as well as the costs to collect and maintain the records of the actual services provided pursuant to the administration's policy for nonemergency medical transportation, transportation network companies and the nonemergency medical transportation broker. In determining the adequacy of the rates in the study, the consulting firm shall examine in detail the costs associated with the delivery of services, including programmatic, administrative, technology and indirect costs in providing nonemergency medical transportation services in rural and urban areas of this state for the transportation providers and the nonemergency medical transportation broker. C. Pursuant to subsection B of this section, the administration may require the administration's contracted providers and managed care organizations to provide financial data to the administration in the format prescribed by the administration to assist in the study. The administration's contracted providers and managed care organizations shall provide all data required by the administration pursuant to this subsection. d. The complete study of reimbursement rates shall be completed within one calendar year after the administration receives sufficient monies pursuant to subsection A of this section. The administration shall provide the results of the study to the joint legislative budget committee. e. The administration shall include the results of the study conducted pursuant to this section in the administration's next capitation rate request immediately following the completion of the study and in the administration's reimbursement rates for nonemergency medical transportation. If results of the study are not completely incorporated into the capitation rate, the administration shall provide a report to the joint legislative budget committee within thirty days after setting the final capitation rate that includes the reason or reasons for any difference between the actual rates and those included in the study.END_STATUTE |
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| 71 | 80 | | Be it enacted by the Legislature of the State of Arizona: |
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| 73 | 82 | | Section 1. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding section 36-2930.07, to read: |
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| 74 | 83 | | |
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| 75 | 84 | | START_STATUTE36-2930.07. Reimbursement rates; nonemergency medical transportation; study; report |
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| 76 | 85 | | |
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| 77 | 86 | | A. The Arizona health care cost containment system may receive funding from nonemergency medical transportation providers and other interested enterprises to cover the costs of a nonemergency medical transportation rate reimbursement study. |
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| 78 | 87 | | |
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| 79 | 88 | | B. if the Arizona health care cost containment system administration receives sufficient monies pursuant to subsection A of this section for a nonemergency medical transportation rate reimbursement study, the administration shall contract with an independent consulting firm for a study of the adequacy and appropriateness of title XIX reimbursement rates to transportation network companies and nonemergency medical transportation brokers for providing medically necessary nonemergency transportation when transporting members to and from a covered physical or behavioral health service pursuant to sections 36-2907 and 36-2989. The study shall review the costs necessary to meet the requirements for the transportation of members as well as the costs to collect and maintain the records of the actual services provided pursuant to the administration's policy for nonemergency medical transportation, transportation network companies and the nonemergency medical transportation broker. In determining the adequacy of the rates in the study, the consulting firm shall examine in detail the costs associated with the delivery of services, including programmatic, administrative, technology and indirect costs in providing nonemergency medical transportation services in rural and urban areas of this state for the transportation providers and the nonemergency medical transportation broker. |
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| 81 | 90 | | C. Pursuant to subsection B of this section, the administration may require the administration's contracted providers and managed care organizations to provide financial data to the administration in the format prescribed by the administration to assist in the study. The administration's contracted providers and managed care organizations shall provide all data required by the administration pursuant to this subsection. |
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| 83 | 92 | | d. The complete study of reimbursement rates shall be completed within one calendar year after the administration receives sufficient monies pursuant to subsection A of this section. The administration shall provide the results of the study to the joint legislative budget committee. |
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| 85 | 94 | | e. The administration shall include the results of the study conducted pursuant to this section in the administration's next capitation rate request immediately following the completion of the study and in the administration's reimbursement rates for nonemergency medical transportation. If results of the study are not completely incorporated into the capitation rate, the administration shall provide a report to the joint legislative budget committee within thirty days after setting the final capitation rate that includes the reason or reasons for any difference between the actual rates and those included in the study.END_STATUTE |
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