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REFERENCE TITLE: facility fees; prohibition |
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State of Arizona House of Representatives Fifty-sixth Legislature Second Regular Session 2024
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HB 2561 |
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Introduced by Representatives Schwiebert: Contreras P, Crews, Gutierrez, Hernandez A, Quiñonez, Seaman, Terech; Senators Hatathlie, Sundareshan
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An Act
amending title 36, chapter 4, article 2, Arizona Revised Statutes, by adding section 36-434.02; relating to health care institutions.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding section 36-434.02, to read:
36-434.02. Outpatient treatment centers; facility fees; prohibition; violations; civil penalties; reporting; definition
A. Beginning November 1, 2024, an outpatient treatment center that has the same direct owner or indirect owner as a hospital licensed pursuant to this chapter may not charge a facility fee unless the payor is medicare and the facility fee is a reimbursable charge.
B. The director may assess civil penalties pursuant to section 36-431.01 for any violation of this section in an amount not to exceed $5,000 per violation. Each facility fee charged is considered a separate violation of this section. Civil penalties that are collected pursuant to this section shall be deposited, pursuant to sections 35-146 and 35-147, in the health services licensing fund established by section 36-414 and be used for inspections and enforcement of health care institutions.
C. On or before December 1, 2024, each outpatient treatment center that has the same direct owner or indirect owner as a hospital licensed pursuant to this chapter and that charged a facility fee before the effective date of this section shall report to the department all data on the facility fees that were charged and billed in the preceding two years or since the inception of the facility fees charged by that entity, whichever is earlier. The data reported shall be submitted to the department in a department-approved format and shall be posted on the department's public website. The report shall include at least the following:
1. All net patient revenue and the total number of paid claims from facility fees for the following payors:
(a) Medicare.
(b) The Arizona health care cost containment system.
(c) Commercial insurance, including inpatient services from facility fees provided to patients participating in a fully funded health insurance plan or a self-funded health insurance plan.
(d) Workers' compensation insurance.
(e) Self pay.
(f) Any other category of payor.
2. The total net patient revenue and total number of paid claims from facility fees.
D. For the purposes of this section, "facility fee" means any fee that an outpatient treatment center charges or bills for outpatient services and that is both:
1. Intended to compensate the charging entity for its operational expenses.
2. Separate and distinct from a professional fee charged or billed by a health care provider for professional health care services.