Senate Engrossed

 

health care; costs; reimbursement

 

 

 

State of Arizona

Senate

Fifty-sixth Legislature

Second Regular Session

2024

 

 

 

CHAPTER 184

 

SENATE BILL 1402

 

 

 

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:

START_STATUTE20-111. 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. END_STATUTE


 

 

 

APPROVED BY THE GOVERNOR MAY 6, 2024.

 

FILED IN THE OFFICE OF THE SECRETARY OF STATE MAY 6, 2024.