Arizona 55th Legislature - 1st Regular Session Status: Passed Senate

SB 1014 — AHCCCS; chiropractic care; report

Last action — House Second Reading

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 55th Legislature - 1st Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

103 added · 106 removed

Plain-language change summary

In the latest version of SB 1014, a line has been added that requires the Arizona Health Care Cost Containment System (AHCCCS) to report on the inclusion of chiropractic care in covered health services. This change is significant because it aims to enhance the understanding and evaluation of how chiropractic services are integrated into healthcare offerings, potentially allowing for better access to these services for patients who need them.

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SB1014 - 551R - I Ver     PREFILED    DEC 16 2020 REFERENCE TITLE:
SB1014 - 551R - S Ver       Senate Engrossed   AHCCCS;
AHCCCS;
report         State of Arizona Senate Fifty-fifth Legislature First Regular Session       SB 1014   Introduced by Senator Barto     AN ACT   Amending section 36-2907, Arizona Revised Statutes;
report         State of Arizona Senate Fifty-fifth Legislature First Regular Session       SENATE BILL 1014       AN ACT   Amending section 36-2907, Arizona Revised Statutes;
Section 1.  Section 36-2907, Arizona Revised Statutes, is amended to read:
Section 1.
START_STATUTE36-2907.  Covered health and medical services;
Section 36-2907, Arizona Revised Statutes, is amended to read:
START_STATUTE36-2907.
Covered health and medical services;
definition A.  Subject to the limitations and exclusions specified in this section, contractors shall provide the following medically necessary health and medical services:
definition A.
1.  Inpatient hospital services that are ordinarily furnished by a hospital for the care and treatment of inpatients and that are provided under the direction of a physician or a primary care practitioner.  For the purposes of this section, inpatient hospital services exclude services in an institution for tuberculosis or mental diseases unless authorized under an approved section 1115 waiver.
Subject to the limitations and exclusions specified in this section, contractors shall provide the following medically necessary health and medical services:
2.  Outpatient health services 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.
3.  Other laboratory and X‑ray services ordered by a physician or a primary care practitioner.
Inpatient hospital services that are ordinarily furnished by a hospital for the care and treatment of inpatients and that are provided under the direction of a physician or a primary care practitioner.
4.  Medications that are ordered on prescription by a physician or a dentist licensed pursuant to title 32, chapter 11.  Persons who are dually eligible for title XVIII and title XIX services 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 provide a medicare part D prescription drug benefit.
For the purposes of this section, inpatient hospital services exclude services in an institution for tuberculosis or mental diseases unless authorized under an approved section 1115 waiver.
5.  Medical supplies, durable medical equipment, insulin pumps and prosthetic devices ordered by a physician or a primary care practitioner.
2.
Outpatient health services 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.
3.
Other laboratory and X-ray services ordered by a physician or a primary care practitioner.
4.
Medications that are ordered on prescription by a physician or a dentist licensed pursuant to title 32, chapter 11.  Persons who are dually eligible for title XVIII and title XIX services 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 provide a medicare part D prescription drug benefit.
5.
Medical supplies, durable medical equipment, insulin pumps and prosthetic devices ordered by a physician or a primary care practitioner.
6.  For persons who are at least twenty‑one years of age, treatment of medical conditions of the eye, excluding eye examinations for prescriptive lenses and the provision of prescriptive lenses.
6.
7.  Early and periodic health screening and diagnostic services as required by section 1905(r) of title XIX of the social security act for members who are under twenty‑one years of age.
For persons who are at least twenty-one years of age, treatment of medical conditions of the eye, excluding eye examinations for prescriptive lenses and the provision of prescriptive lenses.
8.  Family planning services that do not include 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.
7.
9.  Podiatry services that are performed by a podiatrist who is licensed pursuant to title 32, chapter 7 and ordered by a primary care physician or primary care practitioner.
Early and periodic health screening and diagnostic services as required by section 1905(r) of title XIX of the social security act for members who are under twenty-one years of age.
10.  Nonexperimental transplants approved for title XIX reimbursement.
8.
11.  Dental services as follows:
Family planning services that do not include abortion or abortion counseling.
(a)  Except as provided in subdivision (b) of this paragraph, for persons who are at least twenty‑one years of age, emergency dental care and extractions in an annual amount of not more than $1,000 per member.
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.
(b)  Subject to approval by the centers for medicare and medicaid services, for persons treated at an Indian health service or tribal facility, adult dental services that are eligible for a federal medical assistance percentage of one hundred percent and that are in excess of the limit prescribed in subdivision (a) of this paragraph.
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.
12.  Ambulance and nonambulance transportation, except as provided in subsection G of this section.
9.
13.  Hospice care.
Podiatry services that are performed by a podiatrist who is licensed pursuant to title 32, chapter 7 and ordered by a primary care physician or primary care practitioner.
14.  Orthotics, if all of the following apply:
10.
(a)  The use of the orthotic is medically necessary as the preferred treatment option consistent with medicare guidelines.
Nonexperimental transplants approved for title XIX reimbursement.
(b)  The orthotic is less expensive than all other treatment options or surgical procedures to treat the same diagnosed condition.
11.
(c)  The orthotic is ordered by a physician or primary care practitioner.
Dental services as follows:
15.  Subject to approval by the centers for medicare and medicaid services, medically necessary chiropractic services that are performed by a chiropractor who is licensed pursuant to title 32, chapter 8 and that are ordered by a primary care physician or primary care practitioner 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 request authorization for additional chiropractic services in that same year if additional chiropractic services are medically necessary.
(a) Except as provided in subdivision (b) of this paragraph, for persons who are at least twenty-one years of age, emergency dental care and extractions in an annual amount of not more than $1,000 per member.
B.  The limitations and exclusions for health and medical services provided under this section are as follows:
(b) Subject to approval by the centers for medicare and medicaid services, for persons treated at an Indian health service or tribal facility, adult dental services that are eligible for a federal medical assistance percentage of one hundred percent and that are in excess of the limit prescribed in subdivision (a) of this paragraph.
1.  Circumcision of newborn males is not a covered health and medical service.
12.
2.  For eligible persons who are at least twenty‑one years of age:
Ambulance and nonambulance transportation, except as provided in subsection G of this section.
(a)  Outpatient health services do not include speech therapy.
13.
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(b)  Prosthetic devices do not include hearing aids, dentures, bone‑anchored hearing aids or cochlear implants.  Prosthetic devices, except prosthetic implants, may be limited to $12,500 per contract year.
Hospice care.
(c)  Percussive vests are not covered health and medical services.
14.
(d)  Durable medical equipment is limited to items covered by medicare.
Orthotics, if all of the following apply:
(e)  Nonexperimental transplants do not include pancreas‑only transplants.
(a) The use of the orthotic is medically necessary as the preferred treatment option consistent with medicare guidelines.
(f)  Bariatric surgery procedures, including laparoscopic and open gastric bypass and restrictive procedures, are not covered health and medical services.
(b) The orthotic is less expensive than all other treatment options or surgical procedures to treat the same diagnosed condition.
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.
(c) The orthotic is ordered by a physician or primary care practitioner.
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.
15.
89‑97;
Subject to approval by the centers for medicare and medicaid services, medically necessary chiropractic services that are performed by a chiropractor who is licensed pursuant to title 32, chapter 8 and that are ordered by a primary care physician or primary care practitioner 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 request authorization for additional chiropractic services in that same year if additional chiropractic services are medically necessary.
B.
The limitations and exclusions for health and medical services provided under this section are as follows:
1.
Circumcision of newborn males is not a covered health and medical service.
2.
For eligible persons who are at least twenty-one years of age:
(a) Outpatient health services do not include speech therapy.
(b) Prosthetic devices do not include hearing aids, dentures, bone-anchored hearing aids or cochlear implants.
Prosthetic devices, except prosthetic implants, may be limited to $12,500 per contract year.
(c) Percussive vests are not covered health and medical services.
(d) Durable medical equipment is limited to items covered by medicare.
(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;
42 United States Code section 1396 (1980)).  To the extent possible and practicable, these rules shall provide for the prior approval of medically necessary services provided pursuant to this chapter.
42 United States Code section 1396 (1980)).
E.  The director shall make available home health services in lieu of hospitalization pursuant to contracts awarded under this article.  For the purposes of this subsection, "home health services" means the provision of nursing services, home health aide services or medical supplies, equipment and appliances that are provided on a part‑time or intermittent basis by a licensed home health agency within a member's residence based on the orders of a physician or a primary care practitioner.  Home health agencies shall comply with the federal bonding requirements in a manner prescribed by the administration.
To the extent possible and practicable, these rules shall provide for the prior approval of medically necessary services provided pursuant to this chapter.
F.  The director shall adopt rules for the coverage of behavioral health services for persons who are eligible under section 36‑2901, paragraph 6, subdivision (a).  The administration acting through the regional behavioral health authorities shall establish a diagnostic and evaluation program to which other state agencies shall refer children who are not already enrolled pursuant to this chapter and who may be in need of behavioral health services.  In addition to an evaluation, the administration acting through regional behavioral health authorities shall also identify children who may be eligible under section 36‑2901, paragraph 6, subdivision (a) or section 36‑2931, paragraph 5 and shall refer the children to the appropriate agency responsible for making the final eligibility determination.
E.
G.  The director shall adopt rules providing for transportation services and rules providing for copayment by members for transportation for other than emergency purposes.  Subject to approval by the centers for medicare and medicaid services, nonemergency medical transportation shall not be provided except for stretcher vans and ambulance transportation.
The director shall make available home health services in lieu of hospitalization pursuant to contracts awarded under this article.  For the purposes of this subsection, "home health services" means the provision of nursing services, home health aide services or medical supplies, equipment and appliances that are provided on a part-time or intermittent basis by a licensed home health agency within a member's residence based on the orders of a physician or a primary care practitioner.  Home health agencies shall comply with the federal bonding requirements in a manner prescribed by the administration.
Prior authorization is required for transportation by stretcher van and for medically necessary ambulance transportation initiated pursuant to a physician's direction.  Prior authorization is not required for medically necessary ambulance transportation services rendered to members or eligible persons initiated by dialing telephone number 911 or other designated emergency response systems.
F.
H.  The director may adopt rules to allow the administration, at the director's discretion, to use a second opinion procedure under which surgery may not be eligible for coverage pursuant to this chapter without documentation as to need by at least two physicians or primary care practitioners.
The director shall adopt rules for the coverage of behavioral health services for persons who are eligible under section 36-2901, paragraph 6, subdivision (a).
I.  If the director does not receive bids within the amounts budgeted or if at any time the amount remaining in the Arizona health care cost containment system fund is insufficient to pay for full contract services for the remainder of the contract term, the administration, on notification to system contractors at least thirty days in advance, may modify the list of services required under subsection A of this section for persons defined as eligible other than those persons defined pursuant to section 36‑2901, paragraph 6, subdivision (a).  The director may also suspend services or may limit categories of expense for services defined as optional pursuant to title XIX of the social security act (P.L.
The administration acting through the regional behavioral health authorities shall establish a diagnostic and evaluation program to which other state agencies shall refer children who are not already enrolled pursuant to this chapter and who may be in need of behavioral health services.
89‑97;
In addition to an evaluation, the administration acting through regional behavioral health authorities shall also identify children who may be eligible under section 36-2901, paragraph 6, subdivision (a) or section 36-2931, paragraph 5 and shall refer the children to the appropriate agency responsible for making the final eligibility determination.
G.
The director shall adopt rules providing for transportation services and rules providing for copayment by members for transportation for other than emergency purposes.
Subject to approval by the centers for medicare and medicaid services, nonemergency medical transportation shall not be provided except for stretcher vans and ambulance transportation.
Prior authorization is required for transportation by stretcher van and for medically necessary ambulance transportation initiated pursuant to a physician's direction.
Prior authorization is not required for medically necessary ambulance transportation services rendered to members or eligible persons initiated by dialing telephone number 911 or other designated emergency response systems.
H.
The director may adopt rules to allow the administration, at the director's discretion, to use a second opinion procedure under which surgery may not be eligible for coverage pursuant to this chapter without documentation as to need by at least two physicians or primary care practitioners.
I.
If the director does not receive bids within the amounts budgeted or if at any time the amount remaining in the Arizona health care cost containment system fund is insufficient to pay for full contract services for the remainder of the contract term, the administration, on notification to system contractors at least thirty days in advance, may modify the list of services required under subsection A of this section for persons defined as eligible other than those persons defined pursuant to section 36-2901, paragraph 6, subdivision (a).  The director may also suspend services or may limit categories of expense for services defined as optional pursuant to title XIX of the social security act (P.L.
89-97;
42 United States Code section 1396 (1980)) for persons defined pursuant to section 36‑2901, paragraph 6, subdivision (a).  Such reductions or suspensions do not apply to the continuity of care for persons already receiving these services.
42 United States Code section 1396 (1980)) for persons defined pursuant to section 36-2901, paragraph 6, subdivision (a).
J.  All health and medical services provided under this article shall be provided in the geographic service area of the member, except:
Such reductions or suspensions do not apply to the continuity of care for persons already receiving these services.
1.  Emergency services and specialty services provided pursuant to section 36‑2908.
J.
2.  That the director may allow the delivery of health and medical services in other than the geographic service area in this state or in an adjoining state if the director determines that medical practice patterns justify the delivery of services or a net reduction in transportation costs can reasonably be expected.  Notwithstanding the definition of physician as prescribed in section 36‑2901, if services are procured from a physician or primary care practitioner in an adjoining state, the physician or primary care practitioner shall be licensed to practice in that state pursuant to licensing statutes in that state that are similar to title 32, chapter 13, 15, 17 or 25 and shall complete a provider agreement for this state.
All health and medical services provided under this article shall be provided in the geographic service area of the member, except:
K.  Covered outpatient services shall be subcontracted by a primary care physician or primary care practitioner to other licensed health care providers to the extent practicable for purposes including, but not limited to, making health care services available to underserved areas, reducing costs of providing medical care and reducing transportation costs.
1.
L.  The director shall adopt rules that prescribe the coordination of medical care for persons who are eligible for system services.  The rules shall include provisions for transferring patients and medical records and initiating medical care.
Emergency services and specialty services provided pursuant to section 36-2908.
M.  Notwithstanding section 36‑2901.08, monies from the hospital assessment fund established by section 36‑2901.09 may not be used to provide chiropractic services as prescribed in subsection A, paragraph 15 of this section.
2.
M.  N.  For the purposes of this section, "ambulance" has the same meaning prescribed in section 36‑2201.
That the director may allow the delivery of health and medical services in other than the geographic service area in this state or in an adjoining state if the director determines that medical practice patterns justify the delivery of services or a net reduction in transportation costs can reasonably be expected.
END_STATUTE Sec. 2.  Chiropractic services;
Notwithstanding the definition of physician as prescribed in section 36-2901, if services are procured from a physician or primary care practitioner in an adjoining state, the physician or primary care practitioner shall be licensed to practice in that state pursuant to licensing statutes in that state that are similar to title 32, chapter 13, 15, 17 or 25 and shall complete a provider agreement for this state.
K.
Covered outpatient services shall be subcontracted by a primary care physician or primary care practitioner to other licensed health care providers to the extent practicable for purposes including, but not limited to, making health care services available to underserved areas, reducing costs of providing medical care and reducing transportation costs.
L.
The director shall adopt rules that prescribe the coordination of medical care for persons who are eligible for system services.
The rules shall include provisions for transferring patients and medical records and initiating medical care.
M.
Notwithstanding section 36-2901.08, monies from the hospital assessment fund established by section 36-2901.09 may not be used to provide chiropractic services as prescribed in subsection A, paragraph 15 of this section.
M.
N.
For the purposes of this section, "ambulance" has the same meaning prescribed in section 36-2201.
END_STATUTE Sec. 2.
Chiropractic services;
delayed repeal A.  Subject to approval by the centers for medicare and medicaid services, the Arizona health care cost containment system administration and its contractors may provide medically necessary chiropractic services authorized by section 36‑2907, subsection A, paragraph 15, Arizona Revised Statutes, as added by this act.
delayed repeal A.
B.  The Arizona health care cost containment system administration shall:
Subject to approval by the centers for medicare and medicaid services, the Arizona health care cost containment system administration and its contractors may provide medically necessary chiropractic services authorized by section 36-2907, subsection A, paragraph 15, Arizona Revised Statutes, as added by this act.
1.  Prescribe the qualifying conditions under which the chiropractic services prescribed in section 36‑2907, subsection A, paragraph 15, Arizona Revised Statutes, as added by this act, may be used.
B.
2.  Prescribe provider qualifications for chiropractic services.
The Arizona health care cost containment system administration shall:
3.  Report on chiropractic service utilization and any identified cost savings.
1.
C.  On or before January 21, 2024, the Arizona health care cost containment system administration shall submit a report of its findings regarding the provision of chiropractic services to the governor, the president of the senate and the speaker of the house of representatives and shall provide a copy of the report to the secretary of state.
Prescribe the qualifying conditions under which the chiropractic services prescribed in section 36-2907, subsection A, paragraph 15, Arizona Revised Statutes, as added by this act, may be used.
D.  This section is repealed from and after June 30, 2024.
2.
Prescribe provider qualifications for chiropractic services.
3.
Report on chiropractic service utilization and any identified cost savings.
C.
On or before January 21, 2024, the Arizona health care cost containment system administration shall submit a report of its findings regarding the provision of chiropractic services to the governor, the president of the senate and the speaker of the house of representatives and shall provide a copy of the report to the secretary of state.
D.
This section is repealed from and after June 30, 2024.
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Action History

  1. House Second Reading

  2. House First Reading.

  3. Transmit to House

  4. PASSED

  5. DP

  6. DP

  7. Senate Second Reading

  8. Senate First Reading

  9. Prefiled.

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 92 not signed on · 2 voted No

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (92)

92 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Passed

Passed 27 Yea · 2 Nay · 1 Other
Party YeaNayPresentNot Voting
Democrat 3000
Unaffiliated 19001
Republican 5200
Total 27201
% of votes cast 90%7%0%3%
How each member voted (30)
Member Party Vote
Christine Marsh — Yea
Jamescita Peshlakai — Yea
Juan Mendez — Yea
Karen Fann — Yea
Kelly Townsend — Yea
Kirsten Engel — Yea
Lisa Otondo — Yea
Martin Quezada — Yea
Michelle B. Ugenti-Rita — Not Voting
Nancy Barto — Yea
Paul Boyer — Yea
Rebecca Rios — Yea
Rick Gray — Yea
Rosanna Gabaldon — Yea
Sean Bowie — Yea
Sine Kerr — Yea
Sonny Borrelli — Yea
Tony Navarrete — Yea
Tyler Pace — Yea
Victoria Steele — Yea
Lela Alston Democrat Yea
Lupe Contreras Democrat Yea
Sally Ann Gonzales Democrat Yea
David Gowan Republican Yea
David Livingston Republican Nay
J.D. Mesnard Republican Yea
Thomas "T.J." Shope Republican Yea
Venden "Vince" Leach Republican Yea
Warren Petersen Republican Nay
Wendy Rogers Republican Yea

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Subjects

healthcare health-insurance
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Frequently asked questions

Who sponsors SB 1014?
SB 1014 is sponsored by Nancy Barto.
What is the current status of SB 1014?
This bill died with 55th Legislature - 1st Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 1014?
Track SB 1014 free on One Click Politics — get push/email alerts when it moves.

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