SB 1086 — AHCCCS; noncontracting providers; reimbursement

Fifty-seventhSenate LegislatureEngrossed HealthAHCCCS; and Human Services Second Regular Session S.B.

1086noncontracting PROPOSEDproviders; SENATE AMENDMENTS TO S.B.

reimbursement State of Arizona Senate Fifty-seventh Legislature Second Regular Session SENATE BILL 1086 (ReferenceAN toACT printedAMENDING bill)TITLE Amendment36, instructionCHAPTER key:29, ARTICLE 1, ARIZONA REVISED STATUTES, BY ADDING SECTION 36-2905.05;

[GREENRELATING UNDERLININGTO INTHE BRACKETS]ARIZONA indicatesHEALTH textCARE addedCOST toCONTAINMENT statuteSYSTEM. or previously enacted session law.

[Green(TEXT underliningOF inBILL brackets]BEGINS indicatesON textNEXT addedPAGE) to- newi session- lawS.B. or text restoring existing law.

[GREEN1086 STRIKEOUTBe INit BRACKETS]enacted indicatesby newthe textLegislature removedof fromthe statuteState orof previouslyArizona: enacted session law.

[Green strikeout in brackets] indicates text removed from existing statute, previously enacted session law or new session law.

<<Green carets>> indicate a section added to the bill.

<<Green strikeout in carets>> indicates a section removed from the bill.

The bill as proposed to be amended is reprinted as follows:

prohibitions [A.A.

NOTWITHSTANDING ANY OTHER LAW TO THE CONTRARY:]CONTRARY: [A.] [1.] A CONTRACTOR SHALL REIMBURSE A NONCONTRACTING PROVIDER FOR LABORATORY SERVICES RENDERED TO A MEMBER WHO IS ENROLLED WITH THE CONTRACTOR IF THE MEMBER WAS REFERRED BY A CONTRACTED PROVIDER [OF THE CONTRACTOR AT A RATE THAT IS NOT MORE THAN THE RATE THAT WOULD BE REIMBURSED TO A CONTRACTING PROVIDER].

[B.]1. [2.] A CONTRACTOR MAY NOT REQUIRE PRIOR AUTHORIZATION FOR DIAGNOSTIC SERVICES.

[C.]A [B.]CONTRACTOR SHALL REIMBURSE A CONTRACTORNONCONTRACTING MAYPROVIDER NOTFOR TAKELABORATORY ORSERVICES THREATENRENDERED TO TAKEA RETALIATORYMEMBER ACTIONWHO AGAINSTIS ENROLLED WITH THE CONTRACTOR IF THE MEMBER WAS REFERRED BY A CONTRACTED PROVIDER FOROF REFERRINGTHE CONTRACTOR AT A MEMBERRATE THAT IS NOT MORE THAN THE RATE THAT WOULD BE REIMBURSED TO A NONCONTRACTEDCONTRACTING PROVIDER.

Senate Amendments to S.B.

1086 Sec.

A CONTRACTOR MAY NOT REQUIRE PRIOR AUTHORIZATION FOR DIAGNOSTIC SERVICES.

B.

A CONTRACTOR MAY NOT TAKE OR THREATEN TO TAKE RETALIATORY ACTION AGAINST A CONTRACTED PROVIDER FOR REFERRING A MEMBER TO A NONCONTRACTED PROVIDER.

Sec.

2.

Enroll- and1 engross- to conform Amend title to conform CARINE WERNER 1086WERNER.docx 02/10/2026 2:33 PM C:

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