REFERENCE TITLE: billing limits; health care providers

State of Arizona Senate Fifty-fourth Legislature Second Regular Session 2020

SB 1469

Introduced by Senators Dalessandro: Bradley, Gonzales, Otondo, Steele

 

AN ACT

 

Amending Title 20, chapter 20, article 2, Arizona Revised Statutes, by adding section 20-3113.01; relating to health care services.

 

 

(TEXT OF BILL BEGINS ON NEXT PAGE)

 

Be it enacted by the Legislature of the State of Arizona:

Section 1.  Title 20, chapter 20, article 2, Arizona Revised Statutes, is amended by adding section 20-3113.01, to read:

START_STATUTE20-3113.01.  Surprise out-of-network bill; limit; billed amount

If, after deducting the enrollee's cost sharing requirements and the health insurer's allowable reimbursement, the amount of the surprise out‑of‑network bill for which the enrollee is responsible for all related health care services provided by the health care provider, whether contained in one or multiple bills, is less than $1,000, a health care provider may not bill the enrollee or health insurer for the health care services more than one hundred fifty percent of the applicable medicare reimbursement rate.  The health insurer's liability is limited to that amount for the health care services that are the subject of the surprise out‑of‑network bill.END_STATUTE

Sec. 2.  Department of health services; rules; nonprofit hospitals; charity care; delayed repeal

A.  The department of health services shall adopt rules that require nonprofit hospitals to adopt policies regarding the provision of free or reduced‑cost medically necessary services to patients who are determined unable to pay for the health care services received.  The rules shall include:

1.  Income guidelines that are consistent with the guidelines applicable to health care facilities in this state that are obligated under federal law to provide free or reduced‑cost health care services.

2.  The requirement that on admission or, in cases of emergency admission, before discharge of a patient, a hospital must investigate the patient's insurance coverage and eligibility for any state or federal programs of medical assistance.

3.  The requirement that patients are provided notice and the opportunity for a fair hearing regarding eligibility for charity care.

4.  Annual reporting requirements to the department of health services that quantify the amount of free or reduced‑cost services provided.

B.  This section is repealed from and after December 31, 2021.