Second Regular Session H.B. 2194
PROPOSED
SENATE AMENDMENTS TO H.B. 2194
(Reference to House engrossed bill)
Strike everything after the enacting clause and insert:
"Section 1. Title 32, chapter 32, Arizona Revised Statutes, is amended by adding article 2.1, to read:
ARTICLE 2.1. POST‑TRAUMATIC STRESS DISORDER
AND TRAUMATIC BRAIN INJURY TREATMENT
32-3236. Definitions
In this article, unless the context otherwise requires:
1. "Eligible patient" means:
(a) For the purposes of integrated trauma treatment, a veteran, FIRST RESPONDER or other patient who is diagnosed with post‑traumatic stress disorder, POST‑TRAUMATIC STRESS OR trauma.
(b) For the purposes of hyperbaric oxygen therapy, a veteran who has both of the following:
(i) A diagnosis of traumatic brain injury that is attested to by the patient's treating health care provider.
(ii) A prescription for hyperbaric oxygen therapy from the patient's treating health care provider.
2. "Health care provider" means:
(a) For the purposes of integrated trauma treatment, a health professional who is trained and licensed to perform INTEGRATED TRAUMA TREATMENT.
(b) For the purposes of hyperbaric oxygen therapy, a physician licensed pursuant to chapter 13 or 17 of this title, a nurse practitioner licensed pursuant to chapter 15 of this title or a physician assistant licensed pursuant to chapter 25 of this title.
3. "Health facility" means:
(a) For the purposes of integrated trauma treatment, a behavioral health clinic or an intensive outpatient clinic or place of business, including a mobile medical unit that is supervised by a health care provider.
(b) For the purposes of hyperbaric oxygen therapy, a health care institution licensed pursuant to title 36, chapter 4 or a private office of a health care provider where hyperbaric oxygen therapy is provided.
4. "Hyperbaric oxygen therapy" means the inhalation of one hundred percent oxygen in a total body chamber where atmospheric pressure is increased and controlled and that is used to prevent, treat or cure a disease or condition of an eligible patient.
5. "Integrated trauma treatment" means a nonpharmacologic treatment that meets all of the following:
(a) Has at least one year of measured clinical success treating trauma with the world health organization disablement scale, the short form twelve questions, the outcome rating scale and the session rating scale.
(b) Has been reviewed by a behavioral and health services independent review board in this state.
(c) Processes past traumatic experiences, advances social development, increases well‑being and improves both behavioral and physical health.
6. "Traumatic brain injury":
(a) Means an acquired injury to the brain that is caused by an external physical force and that results in a total or partial functional disability or psychosocial impairment, or both, that adversely affects educational performance.
(b) Includes open or closed head injuries resulting in mild, moderate or severe impairments in one or more areas, including cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem-solving, sensory, perceptual and motor abilities, psychosocial behavior, physical functions, information processing and speech.
(c) Does not include brain injuries that are congenital or degenerative or that are induced by birth trauma.
32-3236.01. Integrated trauma treatment; hyperbaric oxygen therapy; consent
An eligible patient may receive INtegrated trauma treatment or hyperbaric oxygen therapy if the patient signs a mutually agreed-on treatment plan with a health care provider or health facility and consents to treatment after the health care provider or health facility makes the required disclosures pursuant to section 32‑3236.03.
32-3236.02. Costs of treatment or therapy
A health care provider or health facility may offer integrated trauma treatment or hyperbaric oxygen therapy to an eligible patient. A health care provider or health facility may provide integrated trauma treatment or hyperbaric oxygen therapy without receiving compensation or may require an eligible patient to pay the costs of providing or the costs associated with the treatment or therapy if the costs are not covered by a third‑party payor.
32-3236.03. Treatment plan; written informed consent; disclosures; witness
A. The written informed consent for:
1. Integrated trauma treatment shall include, at a minimum, all of the following:
(a) A description of the treatment or therapy used.
(b) A description of the independent review board study results.
(c) A description of the health facility's clinical results.
(d) A statement that new, unanticipated or worse symptoms may result, including the potential harm to self or others and possibly death.
(e) A description of the potentially best and worst outcomes of receiving integrated trauma treatment and the most likely outcome.
2. Hyperbaric oxygen therapy shall include, at a minimum, all of the following:
(a) An explanation of the currently approved products and treatments for the traumatic brain injury from which the veteran suffers.
(b) A description of the potentially best and worst outcomes of using hyperbaric oxygen therapy and the most likely outcome.
(c) A statement that new, unanticipated, different or worse outcomes may result and that the proposed therapy may hasten death.
3. Both integrated trauma treatment and hyperbaric oxygen therapy shall include a statement that:
(a) The treatment plan is based on the health care provider's knowledge and training in integrated trauma treatment or hyperbaric oxygen therapy, the information the eligible patient disclosed to the health care provider and, for the purposes of integrated trauma treatment, the eligible patient's behavioral health assessment.
(b) The eligible patient's health plan, third‑party payor and health care provider are not obligated to pay for any care or treatment necessary as a consequence of having the integrated trauma treatment or hyperbaric oxygen therapy unless the party is specifically required to pay by law or contract.
(c) the eligible patient understands and agrees to be liable for all expenses associated with the integrated trauma treatment or hyperbaric oxygen therapy.
B. Before the eligible patient receives integrated trauma treatment or hyperbaric oxygen therapy, The written informed consent required under this section shall be attested to by the eligible patient or the eligible patient's court‑appointed guardian in the presence of the health care provider or a representative of the health facility and a witness.
32-3236.04. Health profession regulatory boards; AHCCCS; state personnel; prohibitions
A. A health profession regulatory board may not revoke, fail to renew, suspend or take any action against a health care provider based solely on the health care provider's recommendation to an eligible patient regarding access to integrated trauma treatment or hyperbaric oxygen therapy.
B. The Arizona health care cost containment system administration may not take action against a health care provider's or health facility's ability to service medicaid enrollees based solely on the provider's or facility's recommendation to an eligible patient regarding access to integrated trauma treatment or hyperbaric oxygen therapy.
C. An official, employee or agent of this state may not block or attempt to block an eligible patient's access to integrated trauma treatment or hyperbaric oxygen therapy that is performed by a health care provider or health facility. It is not a violation of this subsection for A health care provider to provide Counseling, diagnoses, assessments, advice or recommendations consistent with medical standards of care.
32-3236.05. Exemptions
This article does not:
1. Expand benefits under any health plan.
2. Affect coverage by any third‑party payor of routine patient costs resulting from integrated trauma treatment or hyperbaric oxygen therapy.
3. REquire a health plan, third‑party administrator or government agency to pay costs associated with integrated trauma treatment or hyperbaric oxygen therapy.
4. Require a health facility or hospital to provide new or additional services."
Amend title to conform