The proposed bill, if enacted, would amend current statutes by adding new provisions to the Arizona Revised Statutes regarding the Arizona Health Care Cost Containment System (AHCCCS). Specifically, it would require contractors to reimburse noncontracting providers for laboratory services when a member, enrolled with the contractor, is referred by a contracted provider. The reimbursement rate for these services would not exceed the rate paid to contracting providers. Additionally, the bill prohibits contractors from requiring prior authorization for diagnostic services and from taking retaliatory actions against contracted providers for making referrals to noncontracted providers.

Furthermore, the bill includes a statement of legislative intent aimed at promoting cost controls through competition and preventing monopolistic practices that could disrupt the free market. It emphasizes the need for adequate oversight through rigorous audit practices. Overall, the bill seeks to enhance the reimbursement process for noncontracting providers while ensuring fair treatment and competitive practices within the healthcare system.

Statutes affected:
Introduced Version: 36-2905.05
Senate Engrossed Version: 36-2905.05