REFERENCE TITLE: step therapy; exclusion; medical equipment

State of Arizona

Senate

Fifty-sixth Legislature

Second Regular Session

2024

SB 1253

Introduced by

Senators Shope: Shamp

An Act

amending section 20-3652, Arizona Revised Statutes; relating to step therapy.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 20-3652, Arizona Revised Statutes, is amended to read:

START_STATUTE20-3652. Applicability

A. This article applies to:

1. Any health care plan that is subject to state law regulating insurance, that provides prescription drug benefits and that includes coverage for a step therapy protocol regardless of how that coverage is described.

2. A contractor, agent or similar entity that implements coverage for a step therapy protocol on behalf of a health care plan, including a pharmacy benefit manager or utilization review agent.

B. This article does not apply to a health care provider's order for durable medical equipment that requires frequent and substantial service. For the purposes of this subsection, "durable medical equipment" has the same meaning prescribed in 42 code of federal regulations section 414.202. END_STATUTE