ARIZONA STATE SENATE
RESEARCH STAFF
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JEFFREY ONG |
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LEGISLATIVE RESEARCH ANALYST GOVERNMENT COMMITTEE Telephone: (602) 926 -3171 |
GOVERNMENT COMMITTEE
DATE: February 13, 2018
SUBJECT: Strike everything amendment to S.B. 1469, relating to health insurance; benefits
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Purpose
Outlines requirements for a claim to be paid directly from a health care insurer (insurer) to a health care provider (provider).
Background
An insurer must adjudicate any clean claim from a contracted or noncontracted provider relating to health care insurance coverage within 30 days after the insurer receives the clean claim or within a time period specified by contract. Unless there is an express written contract between the insurer and the provider specifying a period in which approved claims must be paid, the insurer must pay the approved portion of any clean claim within 30 days after the claim is adjudicated (A.R.S. § 20-3102).
A health care insurer includes a disability insurer, group disability insurer, blanket disability insurer, health care services organization, prepaid dental plan organization, hospital service corporation, medical service corporation, dental service corporation, optometric service corporation, or hospital, medical, dental and optometric service corporation (A.R.S. § 20-3101).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires a claim paid by an insurer to go directly to a provider, if an insured person assigns the right to receive benefits for that care to the provider.
2. Specifies an assignment of benefits as outlined does not affect or limit the payment of benefits otherwise payable by the insurer.
3. Defines health care insurer and health care provider.
4. Becomes effective on the general effective date.