This bill proposes significant updates to the Arizona Revised Statutes regarding the termination of contracts with high-volume service providers by managed care organizations. Under the new provisions, a managed care organization must provide written notice to the administration at least ninety days prior to terminating a high-volume service provider's contract without cause. The notice must include comprehensive documentation, such as a network adequacy study that evaluates service provider-to-enrollee ratios, appointment wait times, and the impact on members receiving behavioral health services. Additionally, if there is a dispute regarding the classification of a service provider as high-volume, the administration will review the documentation and make a determination.

Furthermore, the bill stipulates that a managed care organization cannot proceed with the termination until the administration has reviewed the network adequacy study and confirmed that network adequacy standards will still be met post-termination. If the administration finds that standards would not be met, the termination cannot occur unless the organization demonstrates otherwise. The bill also mandates that any network adequacy studies related to contract denials be submitted to the administration and made publicly available, ensuring transparency and accountability in the decision-making process regarding high-volume service providers.

Statutes affected:
Introduced Version: 36-2930.07, 36-2961, 36-3414