ARIZONA HOUSE OF REPRESENTATIVES

HB 2494: health insurers; notice; providers

PRIME SPONSOR: Representative Cobb, LD 5

BILL STATUS: Caucus & COW

                                HHS:  DPA 8-0-0-1

Overview

Creates the statutory framework regarding electronic funds transfer payments and virtual credit card payment methods between a health care provider and a health insurer.

History

Not currently addressed in statute.

Provisions

1. Designates that a contract between a health insurer and health care provider issued, amended or renewed after January 1, 2020 for health care services of the health care enrollees may not restrict the method of payment from the insurer to the provider in which the only acceptable payment method would be:

a. A credit card payment; or

b. Electronic funds transfer payment. (Sec. 1)

2. Requires a health insurer to do the following, if the insurer initiates or changes payments to a provider using electronic funds transfer payments:

a. Notify the provider if any fee is associated with the payment method; and

b. Provide available methods of payment and give clear instructions to the provider on how to select an alternative payment method. (Sec. 1)

3. Stipulates a health insurer that pays a provider with electronic funds transfer payments, including virtual credit card payments, to remit an explanation of benefits with each payment. (Sec. 1)

4. Requires a health insurer that acquires a health care provider network, including providers that are not contracted directly with the health insurer to:

a. Notify each health care provider that is not contracted with the insurer and that is in the same network as the acquiring network; and

b. Allow each health care provider not contracted with the insurer and that is in the same network to opt out of the network or contract with the insurer. (Sec. 1)

5. Defines Terms. (Sec. 1)

Amendments

Committee on Health and Human Services

1. States a health insurer initiating or changing a payment to a health care provider using the standard automated clearinghouse method may not apply any additional charge to the payment other than what is imposed by the providers bank. (Sec. 1)

2. Defines electronic funds transfer payment. (Sec. 1)

3.

4.

5. ---------- DOCUMENT FOOTER ---------

6. Fifty-fourth Legislature                       HB 2494

7. First Regular Session                            Version 2: Caucus & COW

8.

9. ---------- DOCUMENT FOOTER ---------