Bill > SB1441

This bill establishes an out-of-network claim dispute resolution process in Arizona. Key provisions include: - Defining "surprise out-of-network bills" as bills from non-contracted providers at in-network facilities, except in certain cases where the patient was provided proper disclosure. - Allowing patients to seek dispute resolution for surprise out-of-network bills over $1,000, after resolving any health plan appeals. The dispute process involves an informal settlement teleconference and potential arbitration. - Requiring the state insurance department to develop the arbitration procedures and contract with entities to provide qualified arbitrators. - Specifying the information the arbitrator must consider in determining the appropriate payment amount, including average contracted and Medicare/Medicaid rates. - Prohibiting providers from balance billing patients beyond their cost-sharing requirements after the dispute resolution process. - Requiring insurers and providers to share the arbitration costs equally, unless a party fails to participate. - Mandating insurers and providers to notify patients of their rights under this new dispute resolution system. The bill aims to protect patients from surprise out-of-network medical bills and establish a fair process to resolve payment disputes between insurers and non-contracted providers.

https://apps.azleg.gov/BillStatus/BillOverview/69285