REFERENCE TITLE: AHCCCS; fraud prevention

State of Arizona House of Representatives Fiftieth Legislature Second Regular Session 2012

HB 2580

Introduced by Representative Seel

 

AN ACT

 

Amending title 36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36-2930.02; relating to the Arizona health care cost containment system.

 

 

(TEXT OF BILL BEGINS ON NEXT PAGE)

 

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 36-2930.02, to read:

START_STATUTE36-2930.02.  Service providers; fraud prevention; verification of enrollment and identity

A.  Beginning October 1, 2013, before providing nonemergency medical care pursuant to this chapter, a health care provider must verify that the person seeking that care is an eligible member who is currently enrolled pursuant to this chapter.  The provider shall verify the person's status and identity using a verification system prescribed by the administration.

B.  A health care provider must provide documentation of verification with each claim for reimbursement submitted pursuant to this chapter as prescribed by the administration.  The administration shall not process a claim without proper documentation. END_STATUTE

Sec. 2.  Arizona health care cost containment system; fraud prevention at point of service; request for proposals; implementation deadline

A.  On or before October 1, 2012, the Arizona health care cost containment system administration shall issue a request for proposals for a verification system to prevent fraud at the point of service.  The system shall allow physicians and other health care providers to accurately verify before providing nonemergency medical care that the person seeking that care is an eligible member who is currently enrolled in the system pursuant to title 36, chapter 29, Arizona Revised Statutes.

B.  The administration shall implement the verification system on or before October 1, 2013.