eligibility; children's health insurance program

HB2521 - 572R - I Ver

REFERENCE TITLE:
eligibility; children's health insurance program

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

HB 2521

Introduced by

Representatives
Stahl Hamilton: Contreras P, Garcia, Gutierrez, Luna-N�jera, Simacek,
Travers, Villegas, Volk;� Senator Ortiz

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_STATUTE
36-2981.

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 to provide hospitalization and medical care
to members according to 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 October 1, 1999
through September 30, 2023, has income at or below two hundred percent of the
federal poverty level.

(b)
(
a
)
Beginning on October 1, 2023
and for
each fiscal year thereafter
through September 30, 2026
,
subject to the approval of the centers for medicare and medicaid services, has
income at or below two hundred twenty-five percent of the federal poverty
level.

(
b
) Beginning
on October 1, 2026 and for each fiscal year thereafter, has an income at or
below three hundred 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 or tribal organization and that is
authorized to provide services pursuant to Public Law 93-638, as amended.
END_STATUTE