ARIZONA HOUSE OF REPRESENTATIVES

Fifty-fifth Legislature

Second Regular Session

 

HB 2486: health providers; insurers; estimated costs

S/E: DHS; health care costs; report

Sponsor: Representative Wilmeth, LD 15

Committee on Health & Human Services

 

Summary of the Strike-Everything Amendment to HB 2486

Overview

Requires the Department of Health Services (DHS) to produce a report that aggregates all publicly available health care cost data and that investigates the extent to which a variation may exist in the amounts that hospitals charge to insurers.

History

Health care insurers include a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation and a medical service corporation.

Hospital service corporations and medical service corporations are corporations organized under state law for the purposes of establishing, maintaining and operating nonprofit hospital service or medical service plans or a combination of plans. Hospital and medical services may be provided by hospitals or by specified physicians. A health care service organization means any person that undertakes to conduct one or more health care plans. Health care services organizations include a provider-sponsored health care service organization unless the context requires otherwise             (A.R.S. §§ 20-822 and 20-1051).

Provisions

1.   ☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal NoteDirects DHS to issue a report that aggregates all publicly available health care cost data and that investigates the extent to which a variation may exist in the amounts that hospitals charge to insurers. (Sec. 1)

2.   Requires the report to include:

a)   The average amount allowed by major insurance carriers for comparable health care services based on an aggregation of the most common services provided;

b)   A comparison of charged amounts insurers agreed to pay between major hospital systems;

c)   The concentration of health care providers in Arizona to determine whether the market is anticompetitive; and

d)   Any disproportionate impact of the variation in commercial health care hospital rates based on race, gender, income and any other relevant demographic indicator.

3.   Requires, by January 1, 2023, DHS to submit the report of its findings and recommendations to the Governor, President of the Senate, Speaker of the House of Representatives and provide a copy to the Secretary of State. (Sec. 1)

 

4.   Defines the following terms:

a)   Amount allowed;

b)   Average; and

c)   Comparable health care service. (Sec. 1)

5.   Repeals the report on July 1, 2023. (Sec. 1)

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9.                     HB 2486

10.  Initials AG Page 0 Health & Human Services

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