ALANNA BENDEL

ASSISTANT RESEARCH ANALYST

CHERIE STONE

LEGISLATIVE RESEARCH ANALYST

HEALTH & HUMAN SERVICES COMMITTEE

Telephone: (602) 926-3171

ARIZONA STATE SENATE

RESEARCH STAFF

TO:                  MEMBERS OF THE SENATE

HEALTH & HUMAN SERVICES COMMITTEE

DATE:            March 9, 2020

SUBJECT:      Strike everything amendment to H.B. 2132, relating to 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 on a similar measure, the strike-everything amendment to H.B. 2132 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.