ARIZONA STATE SENATE
Fifty-Fifth Legislature, First Regular Session
AMENDED
workers'
compensation; settings; definition
(NOW: workers' compensation; fee schedule; settings)
Purpose
An emergency measure that excludes mail order pharmacies delivering pharmaceutical services to workers' compensation claimants from settings that are not accessible to the general public if certain conditions are met.
Background
Statute requires the Industrial Commission of Arizona (ICA) to fix a schedule of fees to be charged by physicians, physical therapists or occupational therapists attending to injured employees and for prescription medicines required to treat an injured employee. The schedule of fees may include different reimbursement guidelines for medications dispensed in settings that are not accessible to the general public (A.R.S. 23-908).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Excludes mail order pharmacies delivering pharmaceutical services to workers' compensation claimants from settings that are not accessible to the general public, if:
a) the pharmacy does not limit or restrict access to claimants with an affiliation to a medical provider or other entity; and
b) any medical provider or other entity referring a claimant to the pharmacy does not receive or accept any rebate, refund, commission, preference or other consideration as compensation for the referral.
2. Stipulates that the schedule of fees fixed by the ICA does not prohibit:
a) a healthcare provider or pharmacy from entering into a separate contract or network that governs fees, in which case reimbursement must be made according to the applicable contracted charge or negotiated rate; and
b) an employer from directing medical, surgical or hospital care.
3. Makes technical changes.
4. Becomes effective on signature of the Governor, if the emergency clause is enacted.
Amendments Adopted by Committee
Adopted the strike-everything amendment.
Amendments Adopted by Committee of the Whole
Adds an emergency clause.
Amendments Adopted by the House of Representatives
Stipulates that the schedule of fees fixed by the ICA does not prohibit:
o a healthcare provider or pharmacy from entering into a separate contract or network that governs fees, in which case reimbursement must be made according to the applicable contracted charge or negotiated rate; and
o an employer from directing medical, surgical or hospital care.
Senate Action House Action
FIN 1/27/21 DPA/SE 9-0-1 COM 3/16/21 DPA 10-0-0-0
3rd Read 2/9/21 29-0-1 3rd Read 4/1/21 60-0-0
Prepared by Senate Research
April 1, 2021
MG/ML/gs