SB 1320 Summary

• Changes article heading from "Out-of-network claim dispute resolution" to "Surprise out-of-network bills" and amends definitions in Arizona Revised Statutes title 20, chapter 20, article 2.

• Eliminates arbitration process for dispute resolution and repeals sections 20-3114 through 20-3118 related to arbitration procedures.

• Requires enrollees to pay only applicable in-network cost-sharing requirements for emergency services rendered by out-of-network providers, with health insurers reimbursing providers at the greatest of: in-network rates, usual/customary/reasonable rates, Medicare rates, or agreed amounts.

• Prohibits health insurers from imposing greater cost-sharing for non-emergency out-of-network services unless enrollees receive written disclosure of provider status and estimated costs at least a reasonable time before service.

• Requires the Department of Insurance and Financial Institutions to report by November 1, 2022 on the efficacy of surprise billing dispute resolution practices and recommend legislative changes based on best practices from other states.