Bill > SB1629

This bill requires managed care organizations, which are entities that contract with the state or regional behavioral health authorities to provide behavioral health services, to provide at least 90 days' written notice to the administration before terminating a contract with a "high-volume service provider" without cause. A high-volume service provider is defined as one that either provided at least 10% of a specific service for a managed care organization in the previous fiscal year or employs more than 10% of the state's actively licensed behavioral health providers. This notice must include a detailed network adequacy study assessing factors like provider-to-enrollee ratios, appointment wait times, patient volume, and the impact on individuals with disabilities, as well as any proposed mitigation measures. The administration will review this study to ensure that network adequacy standards will continue to be met after the termination. If there's a dispute about whether a provider is high-volume, the administration will make the final decision. The bill also outlines requirements for managed care organizations when declining to contract with new providers due to network adequacy concerns, mandating similar network adequacy studies and public posting of findings.

Budget and Finance, Health and Social Services

https://apps.azleg.gov/BillStatus/BillOverview/85262