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ARIZONA STATE SENATE

Fifty-Fourth Legislature, Second Regular Session

 

FACT SHEET FOR S.B. 1025

 

AHCCCS; chiropractic care; report

Purpose

            Adds chiropractic services ordered by a primary care practitioner or physician to the health and medical services covered by the Arizona Health Care Cost Containment System (AHCCCS). Establishes AHCCCS reporting requirements.

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).

            The anticipated fiscal impact to the state General Fund associated with this legislation is unknown at this time.

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.      Authorizes a primary care physician or practitioner to order up to 20 visits for chiropractic services annually and any additional chiropractic services deemed medically necessary in that same year.

3.      Prohibits monies in the Hospital Assessment Fund from being used to provide chiropractic services.

4.      Allows AHCCCS to provide medically-necessary chiropractic services upon approval by the U.S. Centers for Medicare and Medicaid Services.

5.      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.

6.      Requires AHCCCS, by January 21, 2025, 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.

7.      Repeals AHCCCS chiropractic services reporting requirements on July 1, 2026.

8.      Makes technical and conforming changes.

9.      Becomes effective on the general effective date.

Prepared by Senate Research

January 17, 2020

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