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ARIZONA HOUSE OF REPRESENTATIVESFifty-sixth Legislature Second Regular Session |
Senate: FICO DPA 7-0-0-0 |3rd Read 26-2-2-0 |
SB 1402: health care; costs; reimbursement
Sponsor: Senator Shamp, LD 29
Committee on Health & Human Services
Overview
Permits a health insurer to establish a savings incentive program (program) for medically necessary covered health care services.
History
A health care provider is a person who is licensed in podiatry, chiropractic, medicine and surgery, optometry, osteopathic physicians and surgeons, physical therapy or occupational therapy.
A health insurer is a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation as defined relating to insurance. A health insurer does not include a governmental plan as defined in the Employee Retirement Income Security Act of 1974 (A.R.S. § 32-3216).
Provisions
1. Allows a health insurer to establish a program that provides a savings incentive for enrollees for medically necessary covered health care services that health care providers and health care facilities provide at a price that is below the health insurer's usual reimbursement. (Sec. 1)
2. Permits the program to enable an eligible enrollee who receives covered health care services from a health care provider or health care facility at a price below the health insurer's usual reimbursement to:
a) have the amount the enrollee pays applied toward the enrollee's deductible and out-of-pocket maximum; and
b) be reimbursed for a portion of the amount of the different between the price the enrollee paid and the health insurer's usual reimbursement. (Sec. 1)
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Defines terms. (Sec. 1)
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7. SB 1402
8. Initials AG/MT Page 0 Health & Human Services
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