Arizona SB 1629: technical correction; state facilities

Bill Text

SB1629 - 572R - S Ver 

 Senate Engrossed

 behavioral health; 
 contracts; network adequacy

 State of Arizona

 Senate

 Fifty-seventh Legislature

 Second Regular Session

 2026

 SENATE BILL 1629

AN 
ACT

Amending title 36, chapter 29, article 1, 
Arizona Revised Statutes, by adding section 36-2930.07; amending title 
36, chapter 29, article 2, Arizona Revised Statutes, by adding section 36-2961; 
Amending title 36, chapter 34, article 1, Arizona Revised Statutes, by adding 
section 36-3414; relating to behavioral health services.

(TEXT OF BILL BEGINS ON NEXT PAGE)

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

Section 1.1. Title 
36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding 
section 36-2930.07, to read:

START_STATUTE36-2930.07. Managed care organizations; high-volume service providers; 
termination without cause; written notice; determination of network adequacy; 
definitions

A. Before a managed care organization 
may terminate a high-volume service provider's contract without cause, 
the managed care organization shall submit written notice to the administration 
at least ninety days before the proposed effective date of the termination. 

B. The notice to the administration 
pursuant to subsection A of this section shall include all of the following:

1. Documentation showing that the 
service provider is a high-volume service provider, including the 
specific data sources, calculation methodology and metrics used.

2. A network adequacy study performed 
by the managed care organization that evaluates and documents, at a minimum:

(a) Current and 
projected posttermination service provider-to-enrollee ratios by 
service provider type and geographic service area.

(b) Current 
appointment wait time performance for the affected services.

(c) The patient 
volume and geographic distribution of the affected services.

(d) The impact 
on members who are receiving behavioral health services associated with the 
member's disability.

(e) The 
cumulative effect of all pending or recently completed without-cause 
terminations of high-volume service providers by the managed care 
organization.

(f) Any 
additional factors the managed care organization or the administration 
identifies as relevant to network adequacy.

3. The managed care organization's 
preliminary assessment of the impact of the termination on network adequacy.

4. Any mitigation measures the 
managed care organization is proposing. 

C. If there is a discrepancy between 
the managed care organization and the service provider of whether the service 
provider is a high-volume service provider, the managed care organization 
shall notify the administration and provide documentation supporting the 
managed care organization's decision not to file the written notice pursuant to 
subsection A of this section. The administration shall review the 
documentation and decide whether the managed care organization is required to 
file written notice pursuant to subsection A of this section. the 
administration shall notify the service provider of the decision.

D. A managed care organization may 
not terminate a high-volume service provider without cause until the 
administration has reviewed the managed care organization's network adequacy 
study and has provided written confirmation that applicable network adequacy 
standards will continue to be met after the termination of the high-volume 
service provider.� The administration shall complete its review of the network 
adequacy study within ten business days after receiving the notice pursuant to 
subsection A of this section. 

E. If the administration agrees with 
the managed care organization's decision based on the findings provided, the 
administration shall both: 

1. Post the managed care 
organization's complete network adequacy study, including methodology, data 
sources, metrics and findings, and the administration's determination on the 
administration's public website and send a copy to the chairpersons of the 
senate and house of representatives health and human resources committees, or 
their successor committees, and the governor's office.

2. Provide written notice of the 
administration's determination to the managed care organization. 

F. If the administration determines 
that network adequacy standards would not be met, the managed care organization 
may not proceed with the high-volume service provider's termination 
unless the managed care organization demonstrates to the administration's 
satisfaction that network adequacy standards will be met.

G. If a managed care organization 
declines to contract with a service provider or potential service provider due 
to a determination of network adequacy, the managed care organization shall 
complete and send to the administration a network adequacy study, including the 
specific data sources, calculation methodology and metrics used to support the 
denial decision. �The study must include,