PROPOSED AMENDMENT
SENATE AMENDMENTS TO S.B. 1052
(Reference to printed bill)
Strike everything after the enacting clause and insert:
“Section 1. Section 20-464, Arizona Revised Statutes, is amended to read:
20-464. Prohibiting payment for services to persons other than the assignee; equivalent cost‑sharing requirements; definitions
A. If an insured assigns to a covered health care provider performing services covered by the contract payment for benefits under a disability insurance contract, a group disability insurance contract or a blanket disability contract, the contract does not prohibit assignments and the assignment is delivered to the insurer, payment may be made only to the health care provider to whom payment has been assigned.
B. A health insurer may not impose as a limitation on treatment or level of coverage a copayment, coinsurance or deductible amount that is charged to the insured for services provided by a portal of entry health care provider licensed pursuant to title 32, chapter 8 or 19 that is higher than the copayment, coinsurance or deductible amount that is charged to the insured for the services of a portal of entry health care provider for the same medically necessary treatment or condition.
C. For the purposes of this section:
1. "Health insurer" means a hospital service corporation, a medical service corporation, a hospital, medical, dental and optometric service corporation, a disability insurer, a group disability insurer, a blanket disability insurer or a health care services organization.
2. "Portal of entry health care provider" means a person from whom a patient may receive services and insurance coverage for those services without a referral from a physician who is licensed pursuant to title 32, chapter 13 or 17.
Sec. 2. Section 20-821, Arizona Revised Statutes, is amended to read:
20-821. Scope of article; rules; authority of director
A. Hospital service corporations, medical service corporations, dental service corporations, optometric service corporations and hospital, medical, dental and optometric service corporations incorporated in this state are governed by this article and are exempt from all other provisions of this title, except as expressly provided by this article and any rule adopted by the director pursuant to section 20‑143 relating to contracts of such service corporations. No insurance law enacted after January 1, 1955 applies to such corporations unless the law specifically refers to corporations.
B. Chapter 2, article 12 of this title, sections 20‑223,
20‑234, 20‑261, 20‑261.01, 20‑261.02, 20‑261.03, and 20‑261.04, section 20‑464, subsection B and sections 20‑1133,
20‑1377, 20‑1408, 20‑1692, 20‑1692.01, 20‑1692.02
and 20‑1692.03 and chapters 15, 17 and 20 of this title and any rules
adopted to implement these provisions apply to all corporations governed by
this article.
C. Chapter 21 of this title applies to a hospital service corporation, a medical service corporation or a hospital and medical service corporation.”
Amend title to conform