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REFERENCE TITLE: health insurers; notice; providers |
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State of Arizona House of Representatives Fifty-fourth Legislature First Regular Session 2019
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HB 2494 |
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Introduced by Representative Cobb
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AN ACT
Amending title 20, chapter 2, article 1, Arizona Revised Statutes, by adding sections 20-241 and 20-242; 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 2, article 1, Arizona Revised Statutes, is amended by adding sections 20-241 and 20-242, to read:
20-241. Contracts to provide health care services; form of payment; notice; explanation of benefits; definitions
A. A contract between a health insurer and a health care provider that is issued, amended or renewed on or after January 1, 2020 to provide health care services to the health insurer's enrollees may not restrict the method of payment from the health insurer to the health care provider in which the only acceptable payment method is a credit card payment or an electronic funds transfer payment.
B. If a health insurer initiates or changes payments to a health care provider using electronic funds transfer payments, including virtual credit card payments, the health insurer shall do both of the following:
1. Notify the health care provider if any fee is associated with a particular payment method.
2. Advise the health care provider of the available methods of payment and provide clear instructions to the health care provider as to how to select an alternative payment method.
C. A health insurer that pays a health care provider by using electronic funds transfer payments, including virtual credit card payments, shall remit with each payment the explanation of benefits.
D. For the purposes of this section:
1. "Health care provider" means a person who is licensed, registered or certified as a health care professional under title 32 or a laboratory or durable medical equipment provider that furnishes services to an enrollee and that separately bills the enrollee for the services.
2. "Health insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital, medical, dental and optometric service corporation and includes the health insurer's designee.
20-242. Health insurers; health care provider networks; notice; options; definitions
A. If a health insurer acquires a health care provider network that includes health care providers that are not contracted directly with the health insurer, the health insurer shall:
1. Notify each health care provider that is not contracted with the health insurer and that is in the network of the acquisition of the network.
2. Allow each health care provider that is not contracted with the health insurer and that is in the network to opt out of the network or contract with the health insurer.
B. For the purposes of this section:
1. "Health care provider" means a person who is licensed, registered or certified as a health care professional under title 32 or a laboratory or durable medical equipment provider that furnishes services to an enrollee and that separately bills the enrollee for the services.
2. "Health insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital, medical, dental and optometric service corporation and includes the health insurer's designee.