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Senate Engrossed
health care; costs; reimbursement |
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State of Arizona Senate Fifty-sixth Legislature Second Regular Session 2024
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CHAPTER 184
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SENATE BILL 1402 |
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An Act
amending title 20, chapter 1, article 1, Arizona Revised Statutes, by adding section 20-111; relating to health care services.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding section 20-111, to read:
20-111. Health insurers; savings incentive programs; definitions
A. a health insurer may 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.
B. the program may 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 have the amount the enrollee pays applied toward the enrollee's deductible and out-of-pocket maximum and be reimbursed for a portion of the amount of the difference between the price the enrollee paid and the health insurer's usual reimbursement.
C. For the purposes of this section:
1. "Health care facility" means a hospital, outpatient surgical center, health care laboratory, diagnostic imaging center or urgent care center.
2. "Health care provider" has the same meaning prescribed in section 32-3216.
3. "Health insurer" has the same meaning prescribed in section 32-3216.
4. "USUAL REIMBURSEMENT" MEANS THE AMOUNT THE HEALTH INSURER WOULD ORDINARILY PAY AN IN-NETWORK HEALTH CARE PROVIDER OR AN IN-NETWORK HEALTH CARE FACILITY FOR THE SERVICE.
APPROVED BY THE GOVERNOR MAY 6, 2024.
FILED IN THE OFFICE OF THE SECRETARY OF STATE MAY 6, 2024.