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REFERENCE TITLE: insurance;
optometrists; contracts; covered services |
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State of
Arizona House of
Representatives Fifty-fourth
Legislature Second Regular
Session 2020 |
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HB 2643 |
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Introduced by Representatives Weninger: Blackman, Cobb, Senators Fann,
Livingston |
AN ACT
Amending title
20, chapter 4, article 3, Arizona Revised Statutes, by adding section 20‑849;
Amending title 20, chapter 4, article 9, Arizona Revised Statutes, by adding
section 20‑1057.18; Amending title 20, chapter 6, article 4, Arizona
Revised Statutes, by adding section 20‑1342.07; Amending title 20,
chapter 6, article 5, Arizona Revised Statutes, by adding sections 20‑1402.05
and 20‑1404.05; relating to optometry.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3, Arizona Revised Statutes, is amended by adding section 20-849, to read:
20-849. Contracts;
optometrists; covered services; definition
A. A contract, entered into or
renewed on or after January 1, 2021, between an optometric service corporation
and an optometrist who is licensed to practice in this state shall not require
the optometrist to provide services to an individual covered under a
subscription contract based on a fee set by the optometric service corporation
unless the service for which the fee applies is a covered service under the
individual's subscription contract.
B. This section does not restrict the
ability of an optometric service corporation to establish optometric benefits
for services offered by plans that are administered but not insured by the
optometric service corporation.
C. For the purposes of this section, "covered service" means a service for which any reimbursement is available under a subscription contract without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, exclusion or other limitation.
Sec. 2. Title 20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding section 20-1057.18, to read:
20-1057.18. Contracts;
optometrists; covered services; definition
A. A contract, entered into or
renewed on or after January 1, 2021, between a health care services
organization and an optometrist who is licensed to practice in this state shall
not require the optometrist to provide services to an individual covered under
an evidence of coverage based on a fee set by the health care services
organization unless the service for which the fee applies is a covered service
under the individual's evidence of coverage.
B. This section does not restrict the
ability of a health care services organization to establish optometric benefits
for services offered by plans that are administered but not insured by the
health care services organization.
C. For the purposes of this section, "covered service" means a service for which any reimbursement is available under an evidence of coverage without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, exclusion or other limitation.
Sec. 3. Title 20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding section 20-1342.07, to read:
20-1342.07. Contracts;
optometrists; covered services; definition
A. A contract, entered into or renewed
on or after January 1, 2021, between a disability insurer and an optometrist
who is licensed to practice in this state shall not require the optometrist to
provide services to an individual covered under a disability insurance policy
based on a fee set by the disability insurer unless the service for which the
fee applies is a covered service under the individual's disability insurance
policy.
B. This section does not restrict the
ability of a disability insurer to establish optometric benefits for services
offered by plans that are administered but not insured by the disability
insurer.
C. For the purposes of this section, "covered service" means a service for which any reimbursement is available under a disability insurance policy without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, exclusion or other limitation.
Sec. 4. Title 20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding sections 20-1402.05 and 20-1404.05, to read:
20-1402.05. Contracts;
optometrists; covered services; definition
A. A contract, entered into or
renewed on or after January 1, 2021, between a group disability insurer and an
optometrist who is licensed to practice in this state shall not require the
optometrist to provide services to an individual covered under a group
disability insurance policy based on a fee set by the group disability insurer
unless the service for which the fee applies is a covered service under the
individual's group disability insurance policy.
B. This section does not restrict the
ability of a group disability insurer to establish optometric benefits for
services offered by plans that are administered but not insured by the group
disability insurer.
C. For the purposes of this section, "covered service" means a service for which any reimbursement is available under a group disability insurance policy without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, exclusion or other limitation.
20-1404.05. Contracts;
optometrists; covered services; definition
A. A contract, entered into or
renewed on or after January 1, 2021, between a blanket disability insurer and
an optometrist who is licensed to practice in this state shall not require the
optometrist to provide services to an individual covered under a blanket
disability insurance policy based on a fee set by the blanket disability
insurer unless the service for which the fee applies is a covered service under
the individual's blanket disability insurance policy.
B. This section does not restrict the
ability of a blanket disability insurer to establish optometric benefits for
services offered by plans that are administered but not insured by the blanket
disability insurer.
C. For the purposes of this section,
"covered service" means a service for which any reimbursement is
available under a blanket disability insurance policy without regard to
contractual limitations by a deductible, copayment, coinsurance, waiting
period, annual or lifetime maximum, frequency limitation, alternative benefit
payment, exclusion or other limitation.