Arizona HB 2813: erroneous convictions; compensation

Bill Text

HB2813 - 572R - I Ver 

 REFERENCE TITLE: pharmacy benefits; workers' compensation

 State of Arizona

 House of Representatives

 Fifty-seventh Legislature

 Second Regular Session

 2026

 HB 2813

 Introduced by 

 Representative 
 Livingston

AN 
ACT

amending title 23, chapter 6, article 9, 
arizona revised statutes, by adding section 23-1062.04; relating to 
workers' compensation. 

(TEXT OF BILL BEGINS ON NEXT PAGE)

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

Section 1. Title 23, chapter 6, article 9, 
Arizona Revised Statutes, is amended by adding section 23-1062.04, to read:

START_STATUTE23-1062.04. Pharmacy benefits; pharmacy management network; notice; 
registration; fees; disputes; rules

A. An employer or insurer may 
establish or contract with a formal pharmacy management network to provide 
necessary medications to injured employees. 

B. A formal pharmacy management 
network may contract for reimbursement amounts that are different from the fee 
schedule established by the commission pursuant to section 23-908.� 

C. A formal pharmacy management 
network may not reimburse a pharmacy provider for an amount that is less than 
the pharmacy's actual cost of the medication ordered for the injured employee 
plus the dispensing fee established by the commission. 

D. For the purposes of this section, 
a pharmacy services administrative organization is not considered an employer's 
formal pharmacy management network or an agent of a contract pharmacy or 
dispensing provider. 

E. An informal, voluntary pharmacy 
management network may be used by an injured employee on a voluntary basis and 
is not subject to this section. 

F. An employer or insurer that 
establishes a formal pharmacy management network shall do both of the 
following:

1. When an employer or insurer 
initially establishes the formal pharmacy management network, the employer or 
the insurer shall notify employees by posting a notice in a prominent location 
at the workplace or by providing the information in hardcopy or by electronic 
means that employees may use the pharmacy management network and how to fill a 
prescription. 

2. At the time of a reported injury, 
notify the employee on how to use the formal pharmacy management network and 
provide a list of participating network pharmacies and providers in hardcopy or 
by electronic means.

G. Out-of-network 
prescriptions from retail pharmacies or dispensing providers for medications 
that are reasonably required for the period of disability and that are related 
to a compensable claim shall be reimbursed at the pharmacy fee schedule amount 
established by the commission UNTIL the payor or formal pharmacy management 
network provides to the out-of-network pharmacy or dispensing 
provider a notice that contains all of the following:

1. Notice that the injured employee 
is required to receive prescriptions from a pharmacy or dispensing provider 
that participates in the established formal pharmacy management network. 

2. Notice that future medication 
refills by the out-of-network pharmacy or dispensing provider will 
not be reimbursed.

3. An invitation to the pharmacy or 
dispensing provider to join the formal pharmacy management network, if desired. 

H. A formal pharmacy management 
network shall accept as part of the formal pharmacy management network any 
pharmacy or dispensing provider that is licensed and in good standing and is 
willing to abide by the formal pharmacy management network's contract terms. 

I. A formal pharmacy management 
network shall register with the commission and submit a form as prescribed by 
the commission.� A formal pharmacy management network shall pay a registration 
fee in an amount established by the commission in rule.

J. A formal pharmacy management 
network shall provide a timely process for pharmacies and dispensing providers 
to dispute a denial or amount of reimbursement of a pharmaceutical bill.

K. A formal pharmacy management 
network or a contracted formal pharmacy management network shall perform audits 
of pharmacies and dispensing providers. 

L. A formal pharmacy management 
network or a contracted formal pharmacy management network may not charge 
pharmacies or dispensing providers for any direct or indirect fees associated 
with dispensing, processing or billing of a prescription drug or medication 
that is dispensed to an injured employee or any fee related to the enrollment 
or annual reenrollment of the pharmacy in the network or credentialing. 

M. A pharmacy processing agent or 
third-party biller that accepts the assignment of bills from a pharmacy 
or dispensing provider that is contracted with a formal pharmacy management 
network must be reimbursed at the contractual amount agreed to by the assigning 
pharmacy or dispensing provider. 

N. If a claim is disputed for 
compensability, an injured employee is not required to use a pharmacy or 
dispensing provider in the formal pharmacy management networ