Bill Text: AZ HB2686 | 2011 | Fiftieth Legislature 1st Regular | Introduced
Bill Title: Health insurance; vaccines
Spectrum: Bipartisan Bill
Status: (Failed) 2011-02-17 - House BI Committee action: Discussed and Held [HB2686 Detail]
Download: Arizona-2011-HB2686-Introduced.html
|
REFERENCE TITLE: health insurance; vaccines |
|
State of Arizona House of Representatives Fiftieth Legislature First Regular Session 2011
|
|
HB 2686 |
|
|
|
Introduced by Representatives McCune Davis, Heinz, Hobbs, Jones, Meyer: Brophy McGee, Senator Shooter
|
AN ACT
Amending title 20, chapter 4, article 3, Arizona Revised Statutes, by adding section 20‑848; amending title 20, chapter 4, article 9, Arizona Revised Statutes, by adding section 20‑1057.13; amending title 20, chapter 6, article 4, Arizona Revised Statutes, by adding section 20‑1342.07; amending title 20, chapter 6, article 5, Arizona Revised Statutes, by adding sections 20‑1402.05 and 20‑1404.05; amending title 20, chapter 13, article 1, Arizona Revised Statutes, by adding section 20‑2333; relating to health insurance.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3, Arizona Revised Statutes, is amended by adding section 20-848, to read:
20-848. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2012, between an organization licensed pursuant to this article and a health care provider:
1. Shall not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Shall include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs.
3. Shall include reimbursement to the health care provider for the total cost of administering the vaccine, including the cost of supplies, data entry, vaccine counseling, inventory management and routine nursing activities based on the current year's medicare rates as published by the centers for medicare and medicaid services.
B. A contract that provides coverage for childhood and adolescent vaccines:
1. Shall update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Shall update reimbursement amounts to reflect any changes in child and adolescent vaccine pricing increases within forty‑five days.
3. Shall not impose any deductible, copayment or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
4. Shall not place a dollar limit on childhood and adolescent immunization coverage.
C. An organization licensed pursuant to this article shall reimburse a health care provider within forty‑five days after receiving documentation from the health care provider demonstrating that the immunizations were performed.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 2. Title 20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding section 20-1057.13, to read:
20-1057.13. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2012, between a health care services organization and a health care provider:
1. Shall not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Shall include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs.
3. Shall include reimbursement to the health care provider for the total cost of administering the vaccine, including the cost of supplies, data entry, vaccine counseling, inventory management and routine nursing activities based on the current year's medicare rates as published by the centers for medicare and medicaid services.
B. An evidence of coverage that provides coverage for childhood and adolescent vaccines:
1. Shall update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Shall update reimbursement amounts to reflect any changes in child and adolescent vaccine pricing increases within forty‑five days.
3. Shall not impose any deductible, copayment or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
4. Shall not place a dollar limit on childhood and adolescent immunization coverage.
C. A health care services organization shall reimburse a health care provider within forty‑five days after receiving documentation from the health care provider demonstrating that the immunizations were performed.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 3. Title 20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding section 20-1342.07, to read:
20-1342.07. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2012, between a disability insurer and a health care provider:
1. Shall not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Shall include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs.
3. Shall include reimbursement to the health care provider for the total cost of administering the vaccine, including the cost of supplies, data entry, vaccine counseling, inventory management and routine nursing activities based on the current year's medicare rates as published by the centers for medicare and medicaid services.
B. A disability insurance policy that provides coverage for childhood and adolescent vaccines:
1. Shall update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Shall update reimbursement amounts to reflect any changes in child and adolescent vaccine pricing increases within forty‑five days.
3. Shall not impose any deductible, copayment or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
4. Shall not place a dollar limit on childhood and adolescent immunization coverage.
C. A disability insurer shall reimburse a health care provider within forty‑five days after receiving documentation from the health care provider demonstrating that the immunizations were performed.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 4. Title 20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding sections 20‑1402.05 and 20-1404.05, to read:
20-1402.05. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2012, between a group disability insurer and a health care provider:
1. Shall not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Shall include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs.
3. Shall include reimbursement to the health care provider for the total cost of administering the vaccine, including cost the of supplies, data entry, vaccine counseling, inventory management and routine nursing activities based on the current year's medicare rates as published by the centers for medicare and medicaid services.
B. A group disability policy that provides coverage for childhood and adolescent vaccines:
1. Shall update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Shall update reimbursement amounts to reflect any changes in child and adolescent vaccine pricing increases within forty‑five days.
3. Shall not impose any deductible, copayment or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
4. Shall not place a dollar limit on childhood and adolescent immunization coverage.
C. A group disability insurer shall reimburse a health care provider within forty‑five days after receiving documentation from the health care provider demonstrating that the immunizations were performed.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
20-1404.05. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2012, between a Blanket disability insurer and a health care provider:
1. Shall not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Shall include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs.
3. Shall include reimbursement to the health care provider for the total cost of administering the vaccine, including cost of supplies, data entry, vaccine counseling, inventory management and routine nursing activities based on the current year's medicare rates as published by the centers for medicare and medicaid services.
B. A blanket disability policy that provides coverage for childhood and adolescent vaccines:
1. Shall update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days after publication.
2. Shall update reimbursement amounts to reflect any changes in child and adolescent vaccine pricing increases within forty‑five days.
3. Shall not impose any deductible, copayment or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
4. Shall not place a dollar limit on childhood and adolescent immunization coverage.
C. A blanket disability insurer shall reimburse a health care provider within forty‑five days after receiving documentation from the health care provider demonstrating that the immunizations were performed.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
Sec. 5. Title 20, chapter 13, article 1, Arizona Revised Statutes, is amended by adding section 20-2333, to read:
20-2333. Vaccines; contracts; reimbursement; coverage; definition
A. A contract that is entered into or renewed on or after January 1, 2012, between an accountable health plan and a health care provider:
1. Shall not include any provision that requires the health care provider to assume financial risk for the acquisition costs of vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices for children as a condition of accepting the contract.
2. Shall include reimbursement to the health care provider for the acquisition costs of child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices recommended child and adolescent vaccines according to the current or most recently reported centers for disease control private sector cost plus a minimum of twenty‑one per cent for shipping, handling and storage costs.
3. Shall include reimbursement to the health care provider for the total cost of administering the vaccine, including the cost of supplies, data entry, vaccine counseling, inventory management and routine nursing activities based on the current year's medicare rates as published by the centers for medicare and medicaid services.
B. A health benefit plan that provides coverage for childhood and adolescent vaccines:
1. Shall update enrollee benefits to reflect any changes in child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices within thirty days of publication.
2. Shall update reimbursement amounts to reflect any changes in child and adolescent vaccine pricing increases within forty‑five days.
3. Shall not impose any deductible, copayment or other cost sharing in relation to child and adolescent vaccines recommended by the United States centers for disease control and prevention's advisory committee on immunization practices.
4. Shall not place a dollar limit on childhood and adolescent immunization coverage.
C. An accountable health plan shall reimburse a health care provider within forty‑five days after receiving documentation from the health care provider demonstrating that the immunizations were performed.
D. This section does not apply to limited benefit coverage as defined in section 20‑1137.
E. For the purposes of this section, "private sector cost" means the private sector cost per dose listed on the centers for disease control vaccine price list as published online by the United States centers for disease control and prevention.
