This bill proposes the establishment of a health care claims consumer assistance program within the Arizona Department of Insurance and Financial Institutions. The program aims to support consumers enrolled in or seeking health plans by providing assistance with filing complaints, settling disputes, educating consumers about their rights, and helping them obtain health insurance coverage and federal tax credits. Additionally, health insurers will be required to include a notice about this program in their communications, and the department may contract with a nonprofit entity to manage the program.

The bill also introduces new enforcement measures against health insurers that wrongfully deny or insufficiently cover valid claims. It allows for civil penalties, potential license suspension or revocation, and mandates the department to investigate violations. Furthermore, it requires health insurers to disclose data on wrongful claims denials and compels the department to compile and publish annual reports on denied claims. The bill emphasizes consumer protection and accountability within the health insurance industry, aiming to enhance transparency and support for consumers navigating health care claims.

Statutes affected:
Introduced Version: 20-127