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ARIZONA STATE SENATE
Fifty-Fourth Legislature, Second Regular Session
REVISED
AHCCCS services; diabetes management
Purpose
Requires Arizona Health Care Cost Containment System (AHCCCS) contractors to provide eligible members up to 10 program hours of diabetes outpatient self-management training (DSMT) services annually and prescribes eligibility requirements.
Background
AHCCCS contracts with health professionals
to provide medically-necessary health and medical services to eligible members.
Currently, AHCCCS 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 for an identical measure, the authorization of DSMT services as prescribed in S.B. 1151 would have an anticipated fiscal impact of $1,400,000 to the state General Fund (JLBC fiscal note).
Provisions
1. Requires AHCCCS contractors to annually provide a member up to 10 program hours of DSMT services prescribed by a primary care practitioner, if the member:
a) is initially diagnosed with diabetes;
b) has previously been diagnosed with diabetes and experiences a change in diagnosis, medical condition or treatment regimen; or
c) has previously been diagnosed with diabetes and is not meeting appropriate clinical outcomes.
2. Prohibits monies in the Hospital Assessment Fund from being used to provide DSMT services.
3. Makes technical and conforming changes.
4. Becomes effective on the general effective date.
Revisions
ˇ Corrects the fiscal impact information.
Prepared by Senate Research
February 5, 2020
CRS/AB/kja