Bill Text: AZ HB2648 | 2014 | Fifty-first Legislature 2nd Regular | Introduced
Bill Title: Reimbursement; orthotic and prosthetic devices
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2014-03-25 - Referred to Senate RULES Committee [HB2648 Detail]
Download: Arizona-2014-HB2648-Introduced.html
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REFERENCE TITLE: reimbursement; orthotic and prosthetic devices |
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State of Arizona House of Representatives Fifty-first Legislature Second Regular Session 2014
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HB 2648 |
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Introduced by Representative Brophy McGee
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AN ACT
Amending title 20, chapter 4, article 3, Arizona Revised Statutes, by adding section 20-841.10; amending title 20, chapter 4, article 9, Arizona Revised Statutes, by adding section 20-1057.14; amending title 20, chapter 6, article 4, Arizona Revised Statutes, by adding section 20-1376.06; amending title 20, chapter 6, article 5, Arizona Revised Statutes, by adding section 20-1406.06; Amending title 23, chapter 6, article 1, Arizona Revised Statutes, by adding section 23-908.01; Amending title 36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36-2907.13; relating to orthotic and prosthetic devices.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3, Arizona Revised Statutes, is amended by adding section 20-841.10, to read:
20-841.10. Reimbursement for orthotic and prosthetic devices
A. A corporation may not reimburse a health care provider for an orthotic or prosthetic devise furnished to a subscriber unless all of the following apply:
1. The facility from which the orthotic or prosthetic device was provided is accredited by an accreditation organization approved by the centers for medicare and medicaid services pursuant to 42 Code of Federal Regulations section 424.58.
2. The health care provider is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F).
3. There is a valid prescription for the orthotic or prosthetic devise.
B. A health care provider that does not receive reimbursement for an orthotic or prosthetic devise pursuant to subsection A of this section may not attempt to collect payment or reimbursement for the orthotic or prosthetic device from the subscriber. A subscriber is not responsible for any reimbursement that would otherwise have been paid by the corporation.
Sec. 2. Title 20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding section 20-1057.14, to read:
20-1057.14. Reimbursement for orthotic and prosthetic devices
A. A health care services organization shall not reimburse a health care provider for an orthotic or prosthetic devise furnished to an enrollee unless all of the following apply:
1. The facility from which the orthotic or prosthetic device was provided is accredited by an accreditation organization approved by the centers for medicare and medicaid services pursuant to 42 Code of Federal Regulations section 424.58.
2. The health care provider is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F).
3. There is a valid prescription for the orthotic or prosthetic devise.
B. A health care provider that does not receive reimbursement for an orthotic or prosthetic devise pursuant to subsection A of this section may not attempt to collect payment or reimbursement for the orthotic or prosthetic device from the enrollee. An enrollee is not responsible for any reimbursement that would otherwise have been paid by the health care services organization.
Sec. 3. Title 20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding section 20-1376.06, to read:
20-1376.06. Reimbursement for orthotic and prosthetic devices
A. A disability insurer may not reimburse a health care provider for
an orthotic or prosthetic devise furnished to an insured unless all of the following apply:
1. The facility from which the orthotic or prosthetic device was provided is accredited by an accreditation organization approved by the centers for medicare and medicaid services pursuant to 42 Code of Federal Regulations section 424.58.
2. The health care provider is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F).
3. There is a valid prescription for the orthotic or prosthetic devise.
B. A health care provider that does not receive reimbursement for an orthotic or prosthetic devise pursuant to subsection A of this section may not attempt to collect payment or reimbursement for the orthotic or prosthetic device from the insured. An insured is not responsible for any reimbursement that would otherwise have been paid by the disability insurer.
Sec. 4. Title 20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding section 20-1406.06, to read:
20-1406.06. Reimbursement for orthotic and prosthetic devices
A. A group disability or blanket disability insurer may not reimburse a health care provider for an orthotic or prosthetic devise furnished to an insured unless all of the following apply:
1. The facility from which the orthotic or prosthetic device was provided is accredited by an accreditation organization approved by the centers for medicare and medicaid services pursuant to 42 Code of Federal Regulations section 424.58.
2. The health care provider is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F).
3. There is a valid prescription for the orthotic or prosthetic devise.
B. A health care provider that does not receive reimbursement for an orthotic or prosthetic devise pursuant to subsection A of this section may not attempt to collect payment or reimbursement for the orthotic or prosthetic device from the insured. An insured is not responsible for any reimbursement that would otherwise have been paid by the disability insurer.
Sec. 5. Title 23, chapter 6, article 1, Arizona Revised Statutes, is amended by adding section 23-908.01, to read:
23-908.01. Reimbursement for orthotic or prosthetic devices
A. A workers' compensation carrier, a self‑insured employer or the commission may not reimburse a health care provider for an orthotic or prosthetic devise furnished to an injured employee unless all of the following apply:
1. The facility from which the orthotic or prosthetic device was provided is accredited by an accreditation organization approved by the centers for medicare and medicaid services pursuant to 42 Code of Federal Regulations section 424.58.
2. The health care provider is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F).
3. There is a valid prescription for the orthotic or prosthetic devise.
B. A health care provider that does not receive reimbursement for an orthotic or prosthetic devise pursuant to subsection A of this section may not attempt to collect payment or reimbursement for the orthotic or prosthetic device from the injured employee. An injured employee is not responsible for any reimbursement that would otherwise have been paid by the workers' compensation carrier, self‑insured employer or commission.
Sec. 6. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding section 36-2907.13, to read:
36-2907.13. Reimbursement for prosthetic devices
A. A contractor or the administration may not reimburse a health care provider for a prosthetic devise furnished to a member unless all of the following apply:
1. The facility from which the prosthetic device was provided is accredited by an accreditation organization approved by the centers for medicare and medicaid services pursuant to 42 Code of Federal Regulations section 424.58.
2. The health care provider is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F).
3. There is a valid prescription for the prosthetic devise.
B. A health care provider that does not receive reimbursement for a prosthetic devise pursuant to subsection A of this section may not attempt to collect payment or reimbursement for the prosthetic device from the member. A member is not responsible for any reimbursement that would otherwise have been paid by the contractor or administration.
