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REFERENCE TITLE: health insurance; vaccines |
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State of Arizona House of Representatives Fifty-first Legislature First Regular Session 2013
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HB 2633 |
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Introduced by Representatives McCune Davis, Meyer: Alston, Orr
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AN ACT
amending title 20, chapter 4, article 3, Arizona Revised Statutes, by adding section 20-848; amending title 20, chapter 4, article 9, Arizona Revised Statutes, by adding section 20-1057.13; amending title 20, chapter 6, article 4, Arizona Revised Statutes, by adding section 20-1342.07; amending title 20, chapter 6, article 5, Arizona Revised Statutes, by adding sections 20-1402.05 and 20-1404.05; amending title 20, chapter 13, article 1, Arizona Revised Statutes, by adding section 20-2333; providing for the delayed repeal of sections 20‑848, 20‑1057.13, 20‑1342.07, 20‑1402.05, 20‑1404.05 and 20‑2333, Arizona Revised Statutes, as added by this act; relating to health insurance.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3, Arizona Revised Statutes, is amended by adding section 20-848, to read:
20-848. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2014 between an organization licensed pursuant to this article and a health care provider shall:
1. Not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs. if several vaccines are available with the same vaccine code, the reimbursement may be based on the product with the lowest centers for disease control list price.
3. Include reimbursement to the health care provider for the total cost of administering the vaccine using the current year's medicare rates as published by the centers for medicare and medicaid services as a guideline.
B. A subscription contract that provides coverage for childhood and adolescent vaccines shall:
1. Update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Not impose any deductible or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
3. Not place a dollar limit on childhood and adolescent immunization coverage.
C. An organization licensed pursuant to this article shall recognize the public health service delivery model used by any county health department in this state as a provider of services for reimbursement under this section.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 2. Title 20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding section 20-1057.13, to read:
20-1057.13. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2014 between a health care services organization and a health care provider shall:
1. Not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs. if several vaccines are available with the same vaccine code, the reimbursement may be based on the product with the lowest centers for disease control list price.
3. Include reimbursement to the health care provider for the total cost of administering the vaccine using the current year's medicare rates as published by the centers for medicare and medicaid services as a guideline.
B. An evidence of coverage that provides coverage for childhood and adolescent vaccines shall:
1. Update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Not impose any deductible or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
3. Not place a dollar limit on childhood and adolescent immunization coverage.
C. A health care services organization shall recognize the public health service delivery model used by any county health department in this state as a provider of services for reimbursement under this section.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 3. Title 20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding section 20-1342.07, to read:
20-1342.07. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2014 between a disability insurer and a health care provider shall:
1. Not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs. if several vaccines are available with the same vaccine code, the reimbursement may be based on the product with the lowest centers for disease control list price.
3. Include reimbursement to the health care provider for the total cost of administering the vaccine using the current year's medicare rates as published by the centers for medicare and medicaid services as a guideline.
B. A disability insurance policy that provides coverage for childhood and adolescent vaccines shall:
1. Update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Not impose any deductible or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
3. Not place a dollar limit on childhood and adolescent immunization coverage.
C. A disability insurer shall recognize the public health service delivery model used by any county health department in this state as a provider of services for reimbursement under this section.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 4. Title 20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding sections 20‑1402.05 and 20-1404.05, to read:
20-1402.05. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2014 between a group disability insurer and a health care provider shall:
1. Not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs. if several vaccines are available with the same vaccine code, the reimbursement may be based on the product with the lowest centers for disease control list price.
3. Include reimbursement to the health care provider for the total cost of administering the vaccine using the current year's medicare rates as published by the centers for medicare and medicaid services as a guideline.
B. A group disability policy that provides coverage for childhood and adolescent vaccines shall:
1. Update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Not impose any deductible or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
3. Not place a dollar limit on childhood and adolescent immunization coverage.
C. A group disability insurer shall recognize the public health service delivery model used by any county health department in this state as a provider of services for reimbursement under this section.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
20-1404.05. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2014 between a Blanket disability insurer and a health care provider shall:
1. Not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs. if several vaccines are available with the same vaccine code, the reimbursement may be based on the product with the lowest centers for disease control list price.
3. Include reimbursement to the health care provider for the total cost of administering the vaccine using the current year's medicare rates as published by the centers for medicare and medicaid services as a guideline.
B. A blanket disability policy that provides coverage for childhood and adolescent vaccines shall:
1. Update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Not impose any deductible or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
3. Not place a dollar limit on childhood and adolescent immunization coverage.
C. A blanket disability insurer shall recognize the public health service delivery model used by any county health department in this state as a provider of services for reimbursement under this section.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 5. Title 20, chapter 13, article 1, Arizona Revised Statutes, is amended by adding section 20-2333, to read:
20-2333. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2014 between an accountable health plan and a health care provider shall:
1. Not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs. if several vaccines are available with the same vaccine code, the reimbursement may be based on the product with the lowest centers for disease control list price.
3. Include reimbursement to the health care provider for the total cost of administering the vaccine using the current year's medicare rates as published by the centers for medicare and medicaid services as a guideline.
B. A health benefits plan that provides coverage for childhood and adolescent vaccines shall:
1. Update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days of publication.
2. Not impose any deductible or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
3. Not place a dollar limit on childhood and adolescent immunization coverage.
C. An accountable health plan shall recognize the public health service delivery model used by any county health department in this state as a provider of services for reimbursement under this section.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 6. Delayed repeal
Sections 20‑848, 20‑1057.13, 20‑1342.07, 20‑1402.05, 20‑1404.05 and 20‑2333, Arizona Revised Statutes, as added by this act, are repealed from and after December 31, 2015.