Overview
Arizona is active in promoting price transparency in health care. The state has some protections in place that address surprise billing for emergency services and services from out-of-network providers. This includes creating a solution for settling payment disputes between out-of-network providers and insurers by limiting patients’ liability and allowing for arbitration to settle disputes.
In a push for greater drug pricing transparency and lower drug costs, the state legislature unanimously passed the Prescription Drug Pricing Patient Protection Act in 2018. This act includes prohibitions on “gag clauses” that restrict pharmacies from informing customers about available alternative pricing for medications, as well as on co-pay “clawbacks,” where insured patients’ copayments exceed the total cost of the drug to their insurer or pharmacy benefit manager.
In addition to promoting price transparency, Arizona monitors consolidation in the health care market by requiring nonprofit health care entities to provide notice to the Attorney General of all impending health care transactions with other nonprofit or for-profit entities.
Meanwhile, in 2024 Arizona enacted legislation related to medical review, reimbursements, and appeal procedures, including specific processes for appealing denied claims or services as well as outlining the roles of healthcare insurers and other entities responsible for performing reviews and dealing with appeals.
See below for an overview of existing Arizona state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/9/2023 - 4/22/2023 (2023 term). *Current session bill updates are ongoing. Check back weekly for updates.
SB 1602 – Arizona
Introduced: 2020 Status: Inactive / Dead
Health insurance; surprise out-of-network bills. Provides, among other new provisions, that other than an applicable cost sharing requirement prescribed in this section, an enrollee is not responsible for payment of a surprise out of network …
SB 1603 – Arizona
Introduced: 2023 Status: Enacted
Directs licensed hospitals to comply with federal hospital price transparency regulations and demonstrate its compliance to the Arizona Department of Health Services (DHS). Subjects noncompliant hospitals to a civil penalty.
SB 1679 – Arizona
Introduced: 2021 Status: Inactive / Dead
Health insurers; provider network; denial: If a health care provider requests to join a health care insurer’s provider network and the health care insurer denies the request, the health care insurer shall give the health …
SB 1680 – Arizona
Introduced: 2022 Status: Inactive / Dead
Establishing a Prescription drug affordability board, setting cost affordability review and upper payment limits, requiring annual report and study.
SB 1682 – Arizona
Introduced: 2021 Status: Inactive / Dead
Health care providers; telemedicine: Prescribing, dispensing or furnishing a prescription medication or a prescription-only device to a person if the licensee has not conducted a physical or mental health status examination of that person or …
Ariz. Const. Art. 27, § 1. Regulation of ambulances; powers of legislature: Arizona Constitution – Arizona
Introduced: Status: Enacted
The legislature may provide for the regulation of ambulances and ambulance services in this state in all matters relating to services provided, routes served, response times and charges.
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Ariz. Const. Art. 27, § 2. Health care; definitions: Arizona Constitution – Arizona
Introduced: Status: Enacted
Permits a person to pay directly for healthcare services and prohibits providers from penalizing or fining a person for direct payment.
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Ariz. Rev. Stat. § 10-1817. Merger, interest exchange, conversion, domestication or division; definitions: Close Corporations – Arizona
Introduced: Status: Enacted
A domestic close corporation may be a party to or otherwise undertake a merger, an interest exchange, a conversion, a domestication or a division by complying with chapters 11 and 13 of this title and …
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Ariz. Rev. Stat. § 10-1875. Merger, interest exchange, conversion, domestication or division; definitions: Business Trusts – Arizona
Introduced: Status: Enacted
A domestic business trust may be a party to or otherwise undertake a merger, an interest exchange, a conversion, a domestication or a division by complying with chapters 11 and 13 of this title and …
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Ariz. Rev. Stat. § 10-2240. Merger, interest exchange, conversion, domestication or division; definitions: Professional Corporations – Reorganization and Termination – Arizona
Introduced: Status: Enacted
A domestic professional corporation may be a party to or otherwise undertake a merger, an interest exchange, a conversion, a domestication or a division by complying with chapters 11 and 13 of this title and …
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In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
Arizona has an annual budget cycle; the fiscal year beginning on July 1. State agencies submit budget requests to the Governor by September 1, the Governor submits the proposed budget to the legislature five days after the Legislature convenes. There is no deadline for the Legislature to pass the budget. The Governor has line item veto authority. The Governor is required to submit a balanced budget to the Legislature, but the Legislature is not required to pass a balanced budget.
STATE LEGISLATURE
There are 30 state Senators, and the House of Representatives has 60 members. Both House and Senate serve two-year terms. Arizona has term limits, with Senators and Representatives only allowed to serve for four consecutive terms (or eight years) in each chamber. After a two-year break, former members are eligible for election again. Regular Session starts on the second Monday in January, and is scheduled to last for 100 days, however the House and Senate can mutually vote to extend the Regular Session beyond the 100 days. Bills do not carry over from year to year.