Bill Text: AZ HB2104 | 2021 | Fifty-fifth Legislature 1st Regular | Introduced
Bill Title: DIFI; director; report; surprise billing
Spectrum: Partisan Bill (Democrat 24-0)
Status: (Introduced - Dead) 2021-01-21 - House read second time [HB2104 Detail]
Download: Arizona-2021-HB2104-Introduced.html
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REFERENCE TITLE: DIFI; director; report; surprise billing |
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State of Arizona House of Representatives Fifty-fifth Legislature First Regular Session 2021
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HB 2104 |
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Introduced by Representatives Jermaine: Andrade, Bolding, Butler, DeGrazia, Espinoza, Friese, Stahl Hamilton, Lieberman, Longdon, Meza, Pawlik, Salman, Schwiebert, Sierra, Teller, Terán, Senators Alston, Bowie, Engel, Gabaldon, Mendez, Rios, Steele
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AN ACT
Requiring a report from the director of the department of insurance and financial institutions on surprise billing.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Department of insurance and financial institutions; surprise billing; report; definition
A. On or before January 1, 2022, the director of the department of insurance and financial institutions shall produce a report on surprise billing in this state. The director may contract with one or more entities to produce the report. The report shall include:
1. A review and analysis of applicable federal and state laws regarding surprise billing.
2. How this state's laws or procedures compare to surprise billing laws and procedures of other states.
3. The number and type of surprise billing complaints filed with the department of insurance and financial institutions in the past five years as a percentage of total filed health care claims in this state.
4. Current federal and state resources available to consumers subject to surprise billing.
5. Recommendations for policies to better protect consumers from receiving a surprise bill.
6. A root cause analysis of factors contributing to surprise billing, including the following:
(a) The frequency of out-of-network charges billed at in-network hospitals.
(b) Network adequacy standards and adequacy of regulations for in‑network provider coverage and in-network hospitals.
(c) Consumer education and disclosures for coverage for in-network and out-of-network services and costs and network and benefit design.
(d) The escalation of the claim amounts for out‑of‑network physician billing.
(e) The impact of provider consolidation.
(f) The settings and specialties most frequently resulting in surprise billing.
(g) The impact of hospital exclusive contracts with hospital‑based provider groups.
(h) The oversight of accuracy and adequacy of provider directories and the barriers faced in improving accuracy.
B. The director of the department of insurance and financial institutions shall submit the report to the governor, the president of the senate and the speaker of the house of representatives and provide a copy of this report to the secretary of state.
C. For the purposes of this section, "surprise billing" means billing that results when services are performed by an out‑of‑network health care provider at an in-network facility without the patient knowing the provider is out of network.
