 |
ARIZONA STATE SENATE
Fifty-Fourth Legislature, First Regular Session
AHCCCS; chiropractic coverage.
Purpose
Adds chiropractic services to the health and medical services covered by the Arizona Health Care Cost Containment System (AHCCCS).
Background
AHCCCS contracts with
health professionals to provide medically-necessary health and medical services
to eligible members. Currently, AHCCCS contractors (contractors) are required
to provide: 1) inpatient hospital services; 2) outpatient health services; 3)
laboratory and X-ray services; 4) prescription medications; 5) medical
supplies, durable medical equipment, insulin pumps and prosthetic devices; 6)
treatment of medical conditions of the eye; 7) early and periodic heath
screening and diagnostic services; 8) family planning services; 9) podiatry
services;
10) nonexperimental transplants; 11) emergency dental care; 12) ambulance and
nonambulance transportation; 13) hospice care; and 14) orthotics (A.R.S.
§ 36-2907).
According to AHCCCS, the anticipated fiscal impact associated with this legislation is estimated to be $25,000,000 to AHCCCS Total Fund and $4,900,000 to the state General Fund.
Provisions
1. Requires contractors to provide chiropractic services performed by a licensed chiropractor and ordered by a primary care physician or practitioner, subject to rules adopted by AHCCCS.
2. Prohibits monies in the Hospital Assessment Fund from being used to provide chiropractic services.
3. Allows AHCCCS to provide medically-necessary chiropractic services upon approval by the U.S. Centers for Medicare and Medicaid Services.
4. Requires AHCCCS to:
a) prescribe qualifying conditions under which chiropractic services may be used;
b) prescribe provider qualifications for chiropractic services; and
c) require contractors to report on the use of chiropractic services including alternative treatments and use this reported information to determine whether cost savings were achieved as a result.
5. Requires AHCCCS, by January 1, 2023, to submit a report to the Governor, the President of the Senate, the Speaker of the House of Representatives and the Secretary of State on the cost savings determinations.
6. Repeals reporting requirements and the requirement that AHCCCS prescribe conditions and qualifications for chiropractic services on June 30, 2023.
7. Makes technical and conforming changes.
8. Becomes effective on the general effective date.
Prepared by Senate Research
January 28, 2019
CRS/AB/kja