Insurance & Health Care Committee
54th Legislature - 1st Regular Session, 2019 Wednesday, Jan 23 2019 3:44 PM
Bill Summaries
H2060: PHARMACISTS; PROVIDERS; DRUG THERAPY; REFILLS

Repeals statute allowing pharmacists to dispense a one-time emergency refill for a prescription of a non-controlled medication used to treat an ongoing medical condition under certain conditions.

First sponsor: Rep. Barto (R - Dist 15)


 
H2060: PHARMACISTS; PROVIDERS; DRUG THERAPY; REFILLS 1/22 referred to House hel-hu ser.
H2063: VEHICLE INSURANCE CARDS; ASSIGNED NUMBERS

The number that the Department of Transportation assigns to a vehicle insurer is required to be included on the insurance identification cards issued to the insured, instead of included on all documentary evidence issued by the insurer or an authorized agent of the insurer.

First sponsor: Rep. Biasiucci (R - Dist 5)


 
H2113: DIRECT PRIMARY CARE PROVIDERS; DENTISTS

For the purpose of Title 20 (Insurance), the definition of "primary care provider" is modified to include a licensed dentist. and the definition of "primary health care" is modified to include dental services.

First sponsor: Rep. Griffin (R - Dist 14)


 
H2120: AHCCCS; CHIROPRACTIC COVERAGE

The list of medically necessary health and medical services that Arizona Health Care Cost Containment System (AHCCCS) contractors are required to provide is expanded to include chiropractic services that are performed by a licensed chiropractor and that are ordered by a primary care physician or primary care practitioner pursuant to rules adopted by the AHCCCS Administration.

First sponsor: Rep. Barto (R - Dist 15)
Others: Rep. Blackman (R - Dist 6), Rep. Cobb (R - Dist 5), Rep. Osborne (R - Dist 13)


 
H2120: AHCCCS; CHIROPRACTIC COVERAGE 1/22 referred to House hel-hu ser, appro.
H2135: HEALTH INSURANCE; ASSIGNMENT OF BENEFITS

If an insured assigns the right to receive benefits to a health care provider for care provided to the insured, any direct payment from the insurer to the insured must require a signature from both the insured and the health care provider in order for the insured to receive the payment.

First sponsor: Rep. Cobb (R - Dist 5)
Others: Rep. Biasiucci (R - Dist 5)


 
H2166: UNFAIR CLAIMS PRACTICES; COST SHARING

The list of unfair claim settlement practices for insurers is expanded to include for a health insurer that provides pharmacy benefits or a pharmacy benefits manager that administers pharmacy benefits to fail to include any amount paid for an enrollee or on behalf of an enrollee by another person when calculating the enrollee's total contribution to an out-of-pocket maximum, deductible, copayment, coinsurance or other cost sharing requirement.

First sponsor: Rep. Barto (R - Dist 15)
Others: Rep. Cobb (R - Dist 5)


 
H2167: INSURER RESPONSIBILITY; PHARMACY BENEFITS

An insurer that uses the services of a pharmacy benefits manager, an insurance affiliate, a third-party administrator or a third-party payor in Arizona is responsible for the acts of the pharmacy benefits manager, insurance affiliate, third-party administrator or third-party payor that are within the scope of the "health care plan" (defined elsewhere in statute), including the administration of all patient claims processed.

First sponsor: Rep. Barto (R - Dist 15)
Others: Rep. Cobb (R - Dist 5)


 
H2168: PHARMACIES; FEES; PROHIBITION

A pharmacy benefits manager, insurance affiliate, third-party administrator or third-party payor is prohibited from charging or holding a pharmacy responsible for a fee related to a claim that is not disclosed at the time of claims processing, that is not reported on the remittance advice of an adjudicated claim, or after the initial claim is adjudicated at the point of sale.

First sponsor: Rep. Barto (R - Dist 15)


 
H2175: INSURANCE; THIRD-PARTY ADMINISTRATORS; EXEMPTIONS

For the purpose of statute regulating insurance administrators, the definition of "administrator" is modified to exclude credit card processing companies that do not adjust or settle claims, a qualified marketplace platform on behalf of qualified marketplace contractors that complies with other specified statutory requirements, and a person who collects or remits premiums for group life insurance, group annuities or group or blanket disability insurance if the person does not adjust claims or receive any commissions.

First sponsor: Rep. Weninger (R - Dist 17)


 
H2175: INSURANCE; THIRD-PARTY ADMINISTRATORS; EXEMPTIONS 1/22 referred to House com.
H2285: PHARMACY BENEFIT MANAGERS; PHARMACY BENEFITS

Pharmacy benefit managers are required to update the price and drug changes for each list s/he maintains every seven business days, make available to each network pharmacy the sources used to determine the maximum allowable cost price at the beginning of and on renewal of a contract and at least once annually, and establish an appeal process for maximum allowable cost pricing. These requirements apply to all new and existing contracts between a pharmacy benefit manager and a licensed pharmacy beginning on January 1, 2020. Pharmacy benefit managers are prohibited from restricting a pharmacy from dispensing a 90-day fill of a prescription medication pursuant to State Board of Pharmacy rules if specified conditions exist. A plan sponsor or pharmacy benefit manager cannot prohibit a retail pharmacy from offering the limited delivery of prescription drugs by mail to a patient or the hand delivery of prescription drugs to a patient by an employee or contractor of the pharmacy. Some exceptions.

First sponsor: Rep. Cobb (R - Dist 5)


 
H2376: REQUIREMENTS; ASSOCIATION HEALTH PLANS

An association health plan is authorized to operate in Arizona if the plan is in compliance with applicable federal laws and regulations, and if the plan's governing documents require the plan to be actuarially sound and the plan is actuarially sound.

First sponsor: Rep. Barto (R - Dist 15)
Others: Rep. J. Allen (R - Dist 15), Rep. Finchem (R - Dist 11), Rep. Kern (R - Dist 20), Rep. Lawrence (R - Dist 23), Sen. Livingston (R - Dist 22)


 
H2494: HEALTH INSURERS; NOTICE; PROVIDERS

If a health insurer acquires a health care provider network that includes health care providers that are not contracted directly with the insurer, the insurer is required to notify each provider and allow the provider to opt out of the network or contract with the insurer. A contract between a health insurer and a health care provider that is issued, amended or renewed on or after January 1, 2020 to provide health care services to the health insurer's enrollees is prohibited from restricting the method of payment from the insurer to the provider to a credit card payment or an electronic funds transfer payment. If a health insurer initiates payments to a health care provider using electronic funds transfer payments, the insurer is required to notify the provider if a fee is associated with a payment method, advise the provider of available payment methods, and provide clear instructions to select an alternative payment method.

First sponsor: Rep. Cobb (R - Dist 5)


 
S1004: INSURANCE; SURPLUS LINES; REPORTS; PAYMENTS

Beginning January 1, 2020, the Director of the Department of Insurance is authorized to require that reports and payments relating to surplus lines insurance be submitted electronically. If the Director requires electronic submission, the Dept must include on its official website a list of one or more acceptable third-party services through which a surplus lines broker must submit the reports and payments.

First sponsor: Sen. Livingston (R - Dist 22)


 
S1004: INSURANCE; SURPLUS LINES; REPORTS; PAYMENTS 1/17 from Senate fin do pass.
S1005: INSURANCE; POLICY SUMMARIES

Insurers are authorized to provide or make available a summary of policy coverages and exclusions. If an insurer does so, the summary is required to include specified information. A policy summary is not a replacement for the policy and does not alter the coverages or exclusions under the policy. It is an unfair trade practice for an insurer to provide or use a policy summary that contains false, misleading or deceptive representations or statements.

First sponsor: Sen. Livingston (R - Dist 22)


 
S1005: INSURANCE; POLICY SUMMARIES 1/14 referred to Senate fin.
S1006: INTERNATIONALLY ACTIVE INSURANCE GROUPS; SUPERVISION

The Director of the Department of Insurance is authorized to act as the "group-wide supervisor" (defined) for any "internationally active insurance group" (defined as an insurance holding company system that includes a registered insurer that has premiums written in at least three countries and that meets other specified requirements), or to acknowledge another regulatory official as the group-wide supervisor where the insurance group does not have substantial operations in Arizona. Factors the Director is required to consider when making a determination of the appropriate group-wide supervisor for an internationally active insurance group are listed. The Director is authorized to collect from any registered insurer all information necessary for the determination. If the Director is the group-wide supervisor for an internationally active insurance group, the Director is authorized to engage in a list of supervision activities, including coordinating and communicating with other state, federal and international regulatory agencies. The Director is authorized to adopt rules necessary for the administration of this legislation. A registered insurer subject to this legislation is liable for and required to pay the reasonable expenses of the Director's participation in the administration of this legislation. Due to a potential increase in state revenue, this legislation requires the affirmative vote of at least 2/3 of the members of each house of the Legislature for passage, and becomes effective on signature of the Governor.

First sponsor: Sen. Livingston (R - Dist 22)


 
S1006: INTERNATIONALLY ACTIVE INSURANCE GROUPS; SUPERVISION 1/23 Senate fin amended; report awaited.
S1007: INSURANCE; CORPORATE GOVERNANCE; DISCLOSURE

By June 1 of each year, an insurer, or the insurance group of which the insurer is a member, is required to submit to the Director of the Department of Insurance a "corporate governance annual disclosure" or CGAD (defined) that contains specified information. The CGAD and related documents are recognized as being proprietary and containing trade secrets, and are confidential by law and privileged. The Director is authorized to adopt rules and issue orders necessary to carry out this legislation, and is authorized to take a number of actions in order to assist in the performance of related regulatory duties. The Director is authorized to retain, at the insurer's expense, third-party professionals as may be reasonably necessary to assist the Director in reviewing the CGAD and related information, and provisions governing third-party professionals are established. If an insurer fails without just cause to timely file the CGAD, after notice and a hearing, the Director is authorized to impose a civil penalty of $20 for each day's delay, up to $2,500. Nonseverability clause.

First sponsor: Sen. Livingston (R - Dist 22)


 
S1007: INSURANCE; CORPORATE GOVERNANCE; DISCLOSURE 1/17 from Senate fin do pass.
S1008: INSURANCE; PROHIBITED INDUCEMENTS; EXCEPTIONS

Statute prohibiting insurers from offering items as an inducement to insurance does not prohibit an insurer from offering or providing products or services that are ancillary or related to any insurance coverage and that are intended to minimize or prevent claims or claims-related expenses or harm to the public.

First sponsor: Sen. Livingston (R - Dist 22)


 
S1008: INSURANCE; PROHIBITED INDUCEMENTS; EXCEPTIONS 1/17 from Senate fin with amend #4002.
S1035: INSURANCE; SMALL EMPLOYERS; CONTINUATION COVERAGE

For the purpose of statute regulating continuation of small group insurance coverage, the definition of "small employer" is modified to exclude an employer that employs an average of 20 eligible employees.

First sponsor: Sen. Brophy McGee (R - Dist 28)


 
S1035: INSURANCE; SMALL EMPLOYERS; CONTINUATION COVERAGE 1/23 from Senate hel-hu ser do pass.
S1036: AZ MEDICAL BOARD; CONTINUATION

The statutory life of the Arizona Medical Board is extended eight years to July 1, 2027. Retroactive to July 1, 2019.

First sponsor: Sen. Brophy McGee (R - Dist 28)


 
S1036: AZ MEDICAL BOARD; CONTINUATION 1/23 from Senate hel-hu ser do pass.
S1085: ASSOCIATION HEALTH PLANS

A group or association of employers that forms to establish a bona fide group or association for the purposes of accountable health plans and related federal law is required to meet the primary purpose, commonality and nondiscrimination standards and requirements of federal law. An insurer that issues a health plan to a bona fide group or association is required to notify the Department of Insurance at the time the insurer submits policy form filings. By January 1, 2020, the Dept is required to provide information on the Dept's public website that summarizes the new federal rule on association health plans, the applicable state law and any other pertinent information.

First sponsor: Sen. Brophy McGee (R - Dist 28)
Others: Rep. Barto (R - Dist 15)


 
S1085: ASSOCIATION HEALTH PLANS 1/17 referred to Senate hel-hu ser.
S1086: HEALTH PROFESSIONS; TEMPORARY LICENSURE

Health profession regulatory boards are authorized to grant authority to the board's executive director to issue and approve licenses, certifications and registrations to an applicant or licensee who fulfills all requirements of the applicable state statute and meets other specified requirements. Health profession regulatory boards are authorized to issue a "temporary license" (defined) to allow an applicant who is not a licensee to practice in Arizona if the applicant holds an active an unrestricted license in another state and meets other specified requirements. Health profession regulatory boards are required to approve or deny an application for a temporary license within 30 days. If granted, a temporary license expires the earlier of 30 days after it is granted or on approval or denial of the applicant's license application. Health profession regulatory boards are prohibited from issuing more than two temporary licenses to the same applicant within a consecutive 12-month period. Health profession regulatory boards are authorized to establish an application and fee in rule for temporary licensure.

First sponsor: Sen. Brophy McGee (R - Dist 28)


 
S1086: HEALTH PROFESSIONS; TEMPORARY LICENSURE 1/17 referred to Senate hel-hu ser.
S1089: INSURANCE; TELEMEDICINE

Health and disability insurance policies or contracts are required to provide coverage for any health care services that are provided through telemedicine if the health care service would be covered were it provided in-person, instead of only health care services for a specified list of of conditions. Insurers are prohibited from imposing any unique conditions for coverage on services that are provided through telemedicine, including imposing any originating site restrictions, distinguishing between patients in rural or urban locations or limiting coverage to a subset of medical conditions, medical specialties or settings. Effective January 1, 2020.

First sponsor: Sen. Carter (R - Dist 15)
Others: Sen. S. Allen (R - Dist 6), Rep. Barto (R - Dist 15), Sen. Bowie (D - Dist 18), Sen. Bradley (D - Dist 10), Sen. Brophy McGee (R - Dist 28), Rep. Butler (D - Dist 28), Rep. Cobb (R - Dist 5), Rep. Fernandez (D - Dist 4), Rep. Griffin (R - Dist 14), Rep. A. Hernandez (D - Dist 3), Sen. Navarrete (D - Dist 30), Rep. Udall (R - Dist 25)


 
S1089: INSURANCE; TELEMEDICINE 1/17 referred to Senate hel-hu ser.
S1096: HEALTH PROFESSIONALS DATA; REPOSITORY; APPROPRIATION

The Department of Health Services is required to establish and maintain a health care professional workforce data repository. Beginning January 2, 2021, each health profession regulatory board is required to request from applicants for licensure, certification or registration the designated database information prescribed in rule and transfer the information to the Dept on an annual basis. The Dept is authorized to assist the health profession regulatory boards in complying with a standardized format and securely transferring the data collected. The Dept is required to adopt rules for data security and privacy, specify the conditions of data release and establish a fee to provide the data to persons. The data is not a public record and the Dept is authorized to provide the data only under specified circumstances. Establishes a Healthcare Professionals Workforce Data Repository Advisory Committee to advise the Dept on rules and policies relating to the data repository. The Committee terminates on July 1, 2027. Appropriates and unspecified amount (blank in original) from the general fund in FY2019-20 to the Dept to establish and maintain the repository.

First sponsor: Sen. Carter (R - Dist 15)
Others: Sen. Brophy McGee (R - Dist 28), Rep. Butler (D - Dist 28), Rep. Cobb (R - Dist 5), Sen. Navarrete (D - Dist 30)


 
S1096: HEALTH PROFESSIONALS DATA; REPOSITORY; APPROPRIATION 1/22 referred to Senate higher ed-work dev.
S1097: AHCCCS; CHIROPRACTIC COVERAGE

The list of medically necessary health and medical services that Arizona Health Care Cost Containment System (AHCCCS) contractors are required to provide is expanded to include chiropractic services that are performed by a licensed chiropractor and that are ordered by a primary care physician or primary care practitioner pursuant to rules adopted by the AHCCCS Administration.

First sponsor: Sen. Carter (R - Dist 15)
Others: Sen. Alston (D - Dist 24), Sen. Bowie (D - Dist 18), Sen. Bradley (D - Dist 10), Sen. Brophy McGee (R - Dist 28), Sen. D. Farnsworth (R - Dist 16)


 
S1097: AHCCCS; CHIROPRACTIC COVERAGE 1/22 referred to Senate hel-hu ser, appro.
S1100: INSURANCE; LIVING ORGAN DONORS

An insurer that offers life, disability or long-term care insurance contracts is prohibited from unfairly discriminating against a "living organ donor" (defined) in the offering, issuance, price or conditions of an insurance policy based solely, and without additional actuarial risks, on that person's status as a living organ donor.

First sponsor: Sen. Carter (R - Dist 15)
Others: Sen. Brophy McGee (R - Dist 28)


 
S1100: INSURANCE; LIVING ORGAN DONORS 1/22 referred to Senate hel-hu ser.