Bill Text: AZ SB1321 | 2017 | Fifty-third Legislature 1st Regular | Engrossed
Bill Title: DOI; report; surprise billing
Sponsorship: Bipartisan Bill
Status: (Engrossed - Dead) 2017-03-13 - House BI Committee action: Do Pass, voting: (8-0-0-0-0-0) [SB1321 Detail]
Download: Arizona-2017-SB1321-Engrossed.html
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Senate Engrossed |
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State of Arizona Senate Fifty-third Legislature First Regular Session 2017
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SENATE BILL 1321 |
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AN ACT
Requiring a report from the department of insurance 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; surprise billing; report; definition
A. On or before January 1, 2018, the director of the department of insurance 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 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. Root cause analysis of factors contributing to surprise billing including the following:
(a) Frequency of out-of-network charges billed at in-network hospitals.
(b) Network adequacy standards, adequacy of regulations for in‑network provider coverage and in-network hospitals.
(c) Consumer education and disclosure for coverage for in-network and out-of-network services and costs and network and benefit design.
(d) Escalation of the claim amounts for out‑of‑network physician billing.
(e) Impact of provider consolidation.
(f) Settings and specialties most frequently resulting in surprise bills.
(g) Impact of hospital exclusive contracts with hospital‑based provider groups.
(h) Oversight of accuracy and adequacy of provider directories and the barriers faced in improving accuracy.
B. The report shall be submitted to the governor, the president of the senate and the speaker of the house of representatives and a copy of this report shall be provided 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.
