REFERENCE TITLE: medical services;
purchase; premiums |
State of
Arizona House of
Representatives Fifty-fourth
Legislature Second Regular
Session 2020 |
HB 2427 |
|
Introduced by Representatives Butler: Blanc, Fernandez, Friese, Lieberman,
Longdon, Powers Hannley, Salman, Terán |
AN ACT
Amending title
36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36‑2929.01;
relating to the Arizona health care cost containment system administration.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding section 36-2929.01, to read:
36-2929.01. Medical services purchase program; eligibility; premiums; director's duties; program termination
A. The medical services purchase
program is established in the Arizona health care cost containment system. Beginning October 1, 2021, subject to any
necessary authorization from the centers for medicare and medicaid services,
the administration shall administer the medical services purchase program and
provide persons who are eligible pursuant to this section with access to a
medical benefits plan that includes all the medical services provided under
this article, not including nonemergency transportation, for a monthly premium
to pay the cost of coverage under the medical benefits plan. Medical
benefits plan coverage may be purchased only as individual coverage for each
member of a family.
B. A person is eligible to purchase
medical benefits plan coverage pursuant to this section if the person either:
1. Has been uninsured for at least
six months immediately before applying for coverage.
2. Is no longer eligible for services
under this article because the person has exceeded either:
(a) The income
eligibility limit.
(b) The limit
on the length of eligibility.
C. A person who meets the
requirements of subsection B of this section may not use an available premium
tax credit to purchase the medical benefits plan. The person shall
pay any required copayment and enroll in a managed care plan under the medical services
purchase program.
D. The director shall:
1. Establish fees for participants of
the medical services purchase program. the administration may not
use state monies to administer this program.
2. Determine how premiums for the
medical services purchase program will be set and paid.
3. Determine when to disenroll a
medical services purchase program participant for delinquent payment or
nonpayment of premiums.
4. Establish cost sharing
requirements for the medical services purchase program.
5. Determine how medical services
purchase program participants will be enrolled with participating contractors.
6. Adopt any rule necessary to
administer the medical services purchase program.
E. The administration shall seek any
authorization from the centers for medicare and medicaid services that is
necessary to implement and administer the program under this section, including
the authorization to pool the risk of loss of medical services purchase program
participants with the risk of loss of members who are enrolled in this state's
medicaid program pursuant to this article.
F. A contractor may annually elect to
provide services to medical services purchase program participants.
G. The medical services purchase
program established by this section ends on July 1, 2030 pursuant to section
41-3102.