SB 1097 — AHCCCS; chiropractic coverage.

SB1097 - 541R - H-AppropriationsS -Ver Strike  Everything-Proposed    Fifty-fourthSenate Legislature                                          Engrossed Appropriations        State of Arizona Senate Fifty-fourth Legislature First Regular Session                                                  Session S.B.      SENATE BILL 1097       AN ACT   amending section 36‑2907, Arizona Revised Statutes;

 relating PROPOSEDto HOUSEthe OFArizona REPRESENTATIVEShealth AMENDMENTScare TOcost S.B.containment system.

1097  (Reference  to(TEXT SenateOF engrossedBILL bill)BEGINS ON NEXT PAGE)   StrikeBe everythingit afterenacted by the enactingLegislature clauseof andthe insert:State of Arizona:

"Section 1.  SectionSection 1.  Section 28-3395,36-2907, Arizona Revised Statutes, is amended to read:

START_STATUTE28-3395.  SupremeSTART_STATUTE36-2907.  Covered courthealth authority and duties;medical services;

rules;modifications;

record;related delivery of service requirements;

civildefinition penalty;A.  Subject to the limitations and exclusions specified in this section, contractors shall provide the following medically necessary health and medical services:

definition1.  Inpatient A.  Thehospital supremeservices courtthat mayare contractordinarily withfurnished by a publichospital orfor privatethe agencycare and treatment of inpatients and that doesare notprovided provideunder defensivethe drivingdirection schoolsof ina thisphysician stateor pursuanta toprimary care practitioner.  For the purposes of this articlesection, toinpatient providehospital assistanceservices exclude services in carryingan outinstitution thefor dutiestuberculosis ofor thismental article.diseases unless authorized under an approved section 1115 waiver.

B.  The2.  Outpatient supremehealth courtservices shall:that are ordinarily provided in hospitals, clinics, offices and other health care facilities by licensed health care providers.  Outpatient health services include services provided by or under the direction of a physician or a primary care practitioner, including occupational therapy.

1.  Supervise3.  Other thelaboratory useand ofX‑ray defensiveservices drivingordered schools by thea courtsphysician inor thisa state.primary care practitioner.

2.  Make4.  Medications publicthat theare amountordered ofon theprescription courtby diversiona feephysician assessedor bya eachdentist courtlicensed inpursuant thisto statetitle pursuant32, tochapter this11.  articlePersons who are dually eligible for title XVIII and thetitle totalXIX costservices must obtain available medications through a medicare licensed or certified medicare advantage prescription drug plan, a medicare prescription drug plan or any other entity authorized by medicare to attendprovide a defensivemedicare drivingpart schoolD inprescription eachdrug court.benefit.

3.  Establish5.  Medical ansupplies, automateddurable statewidemedical databaseequipment, forinsulin keepingpumps aand recordprosthetic ofdevices personsordered whoby attenda physician or a defensiveprimary drivingcare school.practitioner.

4.  AdoptSuppliers rulesof thatdurable establishmedical criteriaequipment forshall provide the certificationadministration with complete information about the identity of qualifiedeach defensiveperson drivingwho schoolshas an ownership or controlling interest in their business and instructorsshall usedcomply bywith thefederal courts. bonding Beginningrequirements onin septembera 1,manner 2020,prescribed by the criteriaadministration. shall:

(a)  Require6.  For eachpersons defensivewho drivingare schoolat toleast havetwenty‑one ayears curriculumof thatage, includestreatment educationof on:medical conditions of the eye, excluding eye examinations for prescriptive lenses and the provision of prescriptive lenses.

(i)  Distracted7.  Early driving,and includingperiodic thehealth dangersscreening and diagnostic services as required by section 1905(r) of usingtitle aXIX portableof wirelessthe communicationsocial devicesecurity whileact drivingfor andmembers anywho otherare distractedunder drivingtwenty‑one behaviors.years of age.

(ii)  The8.  Family requirementsplanning prescribedservices bythat sectiondo 28-775,not subsectioninclude A.abortion or abortion counseling.  If a contractor elects not to provide family planning services, this election does not disqualify the contractor from delivering all other covered health and medical services under this chapter.  In that event, the administration may contract directly with another contractor, including an outpatient surgical center or a noncontracting provider, to deliver family planning services to a member who is enrolled with the contractor that elects not to provide family planning services.

(b)  Allow9.  Podiatry aservices defensivethat drivingare schoolperformed toby includea educationalpodiatrist informationwho relatingis licensed pursuant to sectiontitle 28-775,32, subsectionschapter D7 and Eordered inby thea school'sprimary curriculum.care physician or primary care practitioner.

5.  Establish10.  Nonexperimental procedurestransplants approved for courtstitle andXIX schoolsreimbursement. to remit reports that are required by the supreme court.

6.  Certify11.  For andpersons monitorwho defensiveare drivingat schoolsleast twenty‑one years of age, emergency dental care and instructorsextractions thatin servean asannual aamount courtof authorizednot diversionmore program.than one thousand dollars $1,000 per member.

7.  Require12.  Ambulance thatand anonambulance defensivetransportation, drivingexcept schoolas classprovided notin exceedsubsection aG total of fourthis andsection. one-half hours, including any testing, reviewing and grading related to the defensive driving school class.

C.  The13.  Hospice informationcare. contained in the database required by this section is not a public record.

D.  An14.  Orthotics, ownerif ofall a certified defensive driving school in this state may not have a shared use of assetsthe infollowing anotherapply: certified defensive driving school in this state.

E.  The(a)  The supreme court shall require a certified defensive driving school or an applicant for a certified defensive driving school to disclose, under penalty of perjury, any shared use of assets that the schoolorthotic oris themedically applicantnecessary hasas inthe anotherpreferred certifiedtreatment defensiveoption drivingconsistent schoolwith inmedicare thisguidelines. state.

F.  A(b)  The personorthotic mayis fileless aexpensive complaintthan withall theother supremetreatment courtoptions that alleges a violation of subsection D or Esurgical ofprocedures this section.  The person who files the complaint is solely responsible for providing sufficient evidence to sustaintreat the complaint. same Ifdiagnosed acondition. certified defensive driving school that is the subject of the complaint does not contest the complaint, the supreme court shall make a determination based solely on the evidence submitted by the person who files the complaint as to whether the owner violated subsection D or E of this section.

G.  If(c)  The theorthotic supremeis courtordered findsby that a defensivephysician driving school violated subsection D or Eprimary ofcare thispractitioner. section, the supreme court shall revoke the defensive driving school's certification and may impose a civil penalty of not more than $1,000.  If the supreme court revokes a certification pursuant to this subsection, a school may reapply for certification one year after the date of revocation in a manner prescribed by the supreme court.

H.  Subsections15.  Chiropractic D,services E,that Fare andperformed Gby ofa thischiropractor sectionwho applyis licensed pursuant to atitle defensive32, drivingchapter school8 and that holdsare ordered by a certificationprimary oncare physician or afterprimary Novembercare 1,practitioner 2020.pursuant to rules adopted by the administration.  The primary care physician or primary care practitioner may initially order up to twenty visits annually that include treatment and may authorize additional chiropractic services in that same year if the primary care physician or primary care practitioner determines it is medically necessary.

I.  ForB.  The thelimitations purposesand ofexclusions thisfor section,health "shared use of assets" means any property that has value, including financial, intangible and physicalmedical assetsservices andprovided includesunder anythis ofsection theare following:as follows:

1.  A1.  Circumcision commonof computernewborn server.males is not a covered health and medical service.

2.  Office2.  For spaceeligible thatpersons iswho locatedare at theleast sametwenty‑one streetyears addressof orage: that is shared physical space.

3.  Shared(a)  Outpatient revenue.health services do not include speech therapy.

4.  Employees(b)  Prosthetic ordevices staff,do includingnot customerinclude supporthearing andaids, managementdentures, bone‑anchored hearing aids or administrativecochlear personnel,implants.  Prosthetic butdevices, notexcept includingprosthetic instructors.implants, may be limited to twelve thousand five hundred dollars $12,500 per contract year.

5.  Telephone(c)  Percussive services.END_STATUTE"vests Amendare titlenot tocovered conformhealth  and  medical REGINAservices. E.

COBB(d)  Durable  medical  equipment 1097COBBis SElimited 04/02/2019to 4:42items PMcovered C:by medicare.

MU(e)  Nonexperimental  transplants do not include pancreas‑only transplants.

(f)  Bariatric surgery procedures, including laparoscopic and open gastric bypass and restrictive procedures, are not covered health and medical services.

C.  The system shall pay noncontracting providers only for health and medical services as prescribed in subsection A of this section and as prescribed by rule.

D.  The director shall adopt rules necessary to limit, to the extent possible, the scope, duration and amount of services, including maximum limitations for inpatient services that are consistent with federal regulations under title XIX of the social security act (P.L.

89‑97;

79 Stat.