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ARIZONA STATE SENATE
Fifty-Fourth Legislature, Second Regular Session
AMENDED
AHCCCS; chiropractic care; report
Purpose
Adds medically necessary 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).
According to a Joint Legislative Budget Committee fiscal note, S.B. 1025 has an anticipated fiscal impact of $3,900,000 to the state General Fund in FY 2021 and $5,200,000 in FY 2022 (JLBC fiscal note).
Provisions
1. Requires AHCCCS to provide medically necessary chiropractic services performed by a licensed chiropractor and ordered by a primary care physician or practitioner, subject to approval by the Centers for Medicare and Medicaid Services (CMS) and rules adopted by AHCCCS.
2. Allows a primary care physician or practitioner to:
a) order up to 20 visits for medically necessary chiropractic services annually; and
b) request authorization from AHCCCS to order 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 CMS.
5. Requires AHCCCS to:
a) prescribe qualifying conditions under which chiropractic services may be used;
b) prescribe provider qualifications for chiropractic services; and
c) report on chiropractic service utilization and any identified cost savings.
6. Requires AHCCCS, by January 21, 2023, to submit a report on its findings to the Governor, the President of the Senate, the Speaker of the House of Representatives and the Secretary of State.
7. Repeals AHCCCS chiropractic services reporting requirements on July 1, 2023.
8. Makes technical and conforming changes.
9. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole
1. Specifies that all chiropractic services provided by AHCCCS must be medically necessary, subject to approval by CMS.
2. Specifies that a primary care physician or practitioner may request authorization for additional chiropractic services if deemed medically necessary by AHCCCS.
3. Shortens, by two years, the due date for the AHCCCS report to be submitted by January 1, 2023.
4. Repeals AHCCCS chiropractic services reporting requirements on July 1, 2023, rather than July 1, 2025.
Senate Action
HHS 1/22/20 DP 7-0-1
Prepared by Senate Research
February 19, 2020
CRS/AB/kja