AZ Legislative Update – As of March 14, 2025
Posted by [email protected] on Mar. 18, 2025 / Subscribe 0
Friday marked the 61st day of the Arizona 57th Legislature, 1st Regular Session and with only two weeks left to hear bills in committees, agendas will be rather lengthy up until the March 28th deadline.
We are now well into budget season and negotiations between legislative leadership and the Governor’s Office are ongoing; however, we are far from any real semblance of a deal. The latest negotiations are centering around a couple of supplemental budget requests from the Governor to cover expenses for FY 2025 including $122 million to the Division of Developmental Disability and an additional $48 million for Arizona’s private school ESA voucher program. In addition, lawmakers and the Governor are continuing to work out the details on language for an extension of Prop. 123 which is set to expire at the end of June.
Passed by the voters, Prop. 123 increased the amount of state land trust money distributed to public schools over 10 years. Both Republicans and Democrats have expressed a strong desire to renew the measure and send it back to the ballot; however, they have struggled to reach an agreement on how specifically the money should be allocated.
State revenue projections are continuing to look good, with a budget surplus of around $935 million; however, we do not anticipate any real significant spending measures in this year’s budget given concerns about federal cuts and some ongoing funding commitments which in reality essentially leaves revenues flat. Lawmakers have until June 30th to pass a balanced budget.
In the meantime, below, please find a few issues and bills that we would like to highlight this week.
Health Insurance
HB 2175 Claims; Prior Authorization; Conduct (Willoughby): HB 2175 will be heard in the Senate Finance Committee on Monday. A strike-everything amendment will be offered to the bill that will requires a medical director or provider, before a health care insurer may deny a claim that involves medical necessity or experimental status or that requires the use of medical judgment, to individually review the denial. It requires a medical director or provider, before a health care insurer may issue a direct denial of a prior authorization that involves medical necessity or experimental status or that requires the use of medical judgment, to individually review the denial. Additionally, the bill requires, during each individual review of a prior authorization or claim denial, the medical director or provider to exercise independent medical judgment and prohibits the director or provider from relying solely on recommendations derived from any other source.
HB 2109 Forced Organ Harvesting; Insurance; Prohibition (Biasiucci): HB 2190 will be heard on Wednesday in the Senate Health & Human Services Committee. The bill would allow insurance policies, including those from the Arizona Health Care Cost Containment System (AHCCCS), to limit coverage for human organ transplants or post-transplant care under certain conditions. These conditions include if the transplant operation occurs in the People's Republic of China or Hong Kong, or if the organ was procured through sale or donation from those regions. The bill clarifies that these limitations do not require coverage for organ transplants and do not restrict insurers from denying coverage for valid reasons. Additionally, the bill would establish the "Arizona End Organ Harvesting Act," which aims to prohibit insurance coverage for organ transplants that meet the specified criteria. The amendments would be made to various sections of Title 20 and Title 36 of the Arizona Revised Statutes, ensuring that the new provisions are integrated into the existing legal framework.
HB 2693 Genetic Sequencing; Insurance; Prohibition (Biasiucci): HB 2693 will be heard on Wednesday in the Senate Health & Human Services Committee. The bill establishes insurance coverage and Arizona Health Care Cost Containment System (AHCCCS) limitations on genetic sequencing. HB 2693 outlines prohibitions and requirements for health care institutions and research facilities relating to genetic sequencers and software used for genetic sequencing.
SB 1291 Health Insurers; Provider Credentialing; Claims (Angius): SB 1291 will be head in the House Health & Human Services Committee on Monday. The bill proposes significant updates to the current statutes regarding health care provider credentialing and claims processing. Under the new provisions, health insurers would be required to complete the credentialing process within 60 calendar days and load the applicant's information into their billing system within 30 days of receiving a complete credentialing application. Additionally, insurers must acknowledge receipt of applications within seven days and provide detailed notices for any incomplete applications. The bill also stipulates that if a credentialing application is incomplete, insurers must inform the applicant within the same seven-day timeframe and outline the necessary steps to complete the application. Moreover, the bill introduces new requirements for claims processing, mandating that health insurers treat claims from providers who have applied for credentialing as in-network claims if certain conditions are met. These conditions include the provider rendering services to an eligible health plan member after receiving notice of a complete credentialing application and not submitting the claim until after a fully executed network participation contract is in place. The bill also clarifies that health insurers are not liable for claims submitted outside of the contractually required time period if submitted within one year of the service date, and it requires providers to disclose their credentialing status and estimated costs to patients prior to service.
SB 1626 Health Insurance; Surprise Billing; Disputes (Werner): SB 1626 passed out of the House Health & Human Services Committee on Monday, 11-0. The bill specifies that requirements and procedures related to providing notice to an enrollee of the enrollee's statutory right to dispute surprise out of network medical bills, only applies to claims that are not subject to an independent dispute resolution under the federal No Suprises Act.
Insurance Operations
HB 2210 DIFI; Continuation (Livingston): HB 2210 is scheduled to be heard in the Senate Finance Committee on Monday. The bill continues the Arizona Department of Insurance and Financial Institutions for an additional 8 years.
SB 1215 Litigation; Financing; Consumer Protection; Enforcement (Leach): SB 1215 passed out of the Senate on Thursday, 27-1. The bill prescribes consumer protection and key disclosure requirements for litigation financing agreements. Under the bill, a litigation financier may not pay or offer to pay a commission, referral fee or other consideration to legal counsel, a law firm or a licensed health care provider, rather than to any person, for referring a person to the litigation financier. SB 1215 requires a party to an action or the party's counsel of record, except as otherwise stipulated or ordered by a court of competent jurisdiction and made without awaiting a discovery request within 30 days after commencement of an action, to disclose to each other party to the action and any known person, including an insurer, with a preexisting contractual obligation to indemnify or defend a party to the action whether the party or its counsel of record has entered into a litigation financing agreement and the name of the litigation financier.
0 Comments