groundwater transportation fee; website; posting

Plain English Breakdown

The bill text states 'diagnostic services' for prior authorization bans but specifies 'laboratory services' for mandatory reimbursement; the relationship between these two terms is not explicitly defined in the provided text.

AHCCCS Reimbursement Rules for Noncontracting Providers

This law requires AHCCCS health plans to pay non-contracting labs for services if a member was referred by a contracted doctor, while banning prior authorization and retaliation.

What This Bill Does

• Requires contractors to reimburse noncontracting providers for laboratory services when a member is referred by a contracted provider of the contractor.
• Limits the reimbursement rate paid to noncontracting providers so it does not exceed the rate given to contracting providers.
• Prohibits contractors from requiring prior authorization before providing diagnostic services.
• Bans contractors from taking or threatening retaliatory action against contracted providers who refer members to noncontracted providers.

Who It Names or Affects

• AHCCCS health plan contractors
• Contracted healthcare providers
• Noncontracting laboratory and diagnostic service providers
• Members enrolled in AHCCCS plans

Terms To Know

AHCCCS contractor

A health plan that has a prepaid capitated contract with the Arizona Health Care Cost Containment System to provide care.

Noncontracting provider

A healthcare service provider, such as a lab, that does not have a direct contract with an AHCCCS contractor.

Prior authorization

Approval required from the health plan before certain medical services can be provided or paid for.

Limits and Unknowns

• The law applies only to laboratory and diagnostic services, not other types of healthcare.
• Reimbursement is limited to cases where a contracted provider made the referral.
• There may be costs to the state General Fund if these rules limit prior authorization or require new payments.

Official Summary Text

HB2932 - 572R - Senate Fact Sheet

Assigned to
HHS�������������������������������������������������������������������������������������������������������������� AS
PASSED BY COW

ARIZONA STATE SENATE

Fifty-Seventh
Legislature, Second Regular Session

AMENDED

FACT SHEET FOR
H.B. 2932

������������������������������������������������������������������������������������������������������������

groundwater
transportation fee; website; posting

(
NOW: AHCCCS; reimbursement; noncontracting providers
)

Purpose

Requires contractors with the Arizona Health Care Cost Containment System
(AHCCCS) to reimburse noncontracting providers for laboratory services under
specified conditions and prohibits contractors from imposing restrictions or
taking retaliatory actions relating to noncontracting provider referrals.

Background

AHCCCS contracts with health plans to
provide medically necessary health and medical services to eligible members.
AHCCCS contractors are required to provide services and supplies including but
not limited to: 1) inpatient and outpatient hospital services; 2) laboratory
and X-ray services; 3) prescription medications; 4) medical supplies, durable
medical equipment, insulin pumps and prosthetic devices; 5) medical treatment
of eye conditions; 6) early and periodic health screening and diagnostic
services; 7) family planning services; 8) podiatry services;

9) nonexperimental transplants; 10) emergency dental care; 11) ambulance and
nonambulance transportation; 12) hospice care; 13) orthotics; 14) chiropractic
services; 15) diabetes outpatient

self-management training services; and 16) traditional healing services, as
specified (
A.R.S.

� 36-2907
).

Contractor
means a person or entity that has a prepaid capitated
contract with AHCCCS to provide health care to members either directly or
through subcontracts with providers (
A.R.S.

� 36-2901
).

If there is a cost associated with limiting AHCCCS's ability to require
prior authorization and requiring contractors to reimburse noncontracting
providers for specified services, there may be a fiscal impact to the state
General Fund.

Provisions

1.

Requires
an AHCCCS contractor to reimburse a noncontracting provider for laboratory
services rendered to a member who is enrolled with the contractor if the member
was referred by a contracted provider.

2.

Prohibits
a contractor from reimbursing a noncontracting provider at a rate exceeding the
reimbursement rate for contracting providers.

3.

Prohibits
a contractor from requiring prior authorization for diagnostic services.

4.

Prohibits
a contractor from taking or threatening to take retaliatory action against a
contracted provider for referring a member to a noncontracted provider.

5.

Contains
a statement of legislative intent.

6.

Becomes
effective on the general effective date.

Amendments
Adopted by Committee

�

Adopted the strike-everything amendment.

Senate Action

NR����������������� 3/23/26����������� W/D���

HHS��������������� 3/25/26����������� DPA/SE��������� 5-2-0

Prepared by Senate Research

April 8, 2026

MM/MS/hk

������������������������������������������������������������������

Current Bill Text

HB2932 - 572R - S Ver

Senate Engrossed
House Bill

groundwater
transportation fee; website; posting

(now:� AHCCCS;
reimbursement; noncontracting providers)

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

HOUSE BILL 2932

AN
ACT

Amending title 36, chapter 29, article 1,
Arizona Revised Statutes, by adding section 36-2905.05; RELATING to
the
Arizona Health Care Cost Containment System
.

(TEXT OF BILL BEGINS ON NEXT PAGE)

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

Section 1. Title 36, chapter 29, article 1,
Arizona Revised Statutes, is amended by adding section 36-2905.05, to read:

START_STATUTE
36-2905.05.

Contractors; reimbursement; noncontracting providers;
prohibitions

a. nOTWITHSTANDING ANY OTHER LAW TO
THE CONTRARY:

1. A contractor shall reimburse a
noncontracting provider for laboratory services rendered to a member who is
enrolled with the contractor if the member was referred by a contracted
provider
OF THE CONTRACTOR AT A RATE THAT IS NOT MORE
THAN THE RATE THAT WOULD BE REIMBURSED TO A CONTRACTING PROVIDER.

2. A contractor may not require prior
authorization for diagnostic services.

b. A contractor may not take or
threaten to take retaliatory action against a contracted provider for referring
a member to a noncontracted provider.
END_STATUTE

Sec. 2.
Legislative intent

The legislature intends to promote
cost controls through competition and to avoid monopolistic practices that
interfere with the free market. Adequate oversight through rigorous audit
practices is the alternative.