Arizona HB 2137: children's health insurance program; eligibility

Bill Text

HB2137 - 561R - I Ver 

 REFERENCE TITLE: children's health 
 insurance program; eligibility

 State of 
 Arizona

 House of 
 Representatives

 Fifty-sixth 
 Legislature

 First Regular 
 Session

 2023

 HB 2137

 Introduced by 

 Representatives Salman: De Los Santos, Ortiz, Sandoval, Stahl 
 Hamilton

An Act

amending section 
36-2981, Arizona Revised Statutes; relating to the children's health insurance 
program.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 36-2981, Arizona Revised 
Statutes, is amended to read:

START_STATUTE36-2981. Definitions

In this article, unless the context otherwise requires:

1. "Administration" means the Arizona 
health care cost containment system administration.

2. "Contractor" means a health plan that 
contracts with the administration for the provision of to provide hospitalization and medical care to members 
according to the provisions of this article or a 
qualifying plan.

3. "Director" means the director of the 
administration.

4. "Federal poverty level" means the 
federal poverty level guidelines published annually by the United States 
department of health and human services.

5. "Health plan" means an entity that 
contracts with the administration for services provided pursuant to article 1 
of this chapter.

6. "Member" means a person who is eligible 
for and enrolled in the program, who is under nineteen years of age and whose 
gross household income meets the following requirements:

(a) Beginning on November 1, 1998 
through September 30, 1999, has income at or below one hundred fifty per cent 
of the federal poverty level.

(b) (a) Beginning on October 1, 1999 and for 
each fiscal year thereafter through September 30, 2023, 
has income at or below two hundred per cent 
percent of the federal poverty level.

(b) Beginning 
on October 1, 2023 and for each fiscal year thereafter, has income at or below 
two hundred fifty percent of the federal poverty level.

7. "Noncontracting provider" means an 
entity that provides hospital or medical care but does not have a contract or 
subcontract with the administration.

8. "Physician" means a person who is licensed pursuant to title 32, chapter 13 or 17.

9. "Prepaid capitated" means a method of 
payment by which a contractor delivers health care services for the duration of 
a contract to a specified number of members based on a fixed rate per member, 
per month without regard to the number of members who receive care or the 
amount of health care services provided to a member.

10. "Primary care physician" means a 
physician who is a family practitioner, general practitioner, pediatrician, 
general internist, obstetrician or gynecologist.

11. "Primary care practitioner" means a 
nurse practitioner who is certified pursuant to title 32, chapter 15 or a 
physician assistant who is licensed pursuant to title 32, chapter 25 and who is 
acting within the respective scope of practice of those chapters.

12. "Program" means the children's health 
insurance program.

13. "Qualifying plan" means a contractor 
that contracts with the state pursuant to section 38-651 to provide health 
and accident insurance for state employees and that provides services to 
members pursuant to section 36-2989, subsection A.

14. "Special health care district" means a 
special health care district organized pursuant to title 48, chapter 31.

15. "Tribal facility" means a facility 
that is operated by an Indian tribe and that is authorized to provide services 
pursuant to Public Law 93-638, as amended. END_STATUTE