Arizona Laws 20-1073. Eligibility; prohibiting cancellation because of eligibility for certain benefits
A. Except as specifically provided in sections 20-1379 and 20-1380, with respect to the determination of whether a person is an eligible individual, a health care services organization shall not consider the availability of or a person’s eligibility for medical assistance under a program pursuant to title XIX of the social security act (P.L. 89-97; 79 Stat. 344; 42 United States Code § 1396a (1980)) when considering eligibility for coverage or calculating payments under its plan for eligible enrollees.
Terms Used In Arizona Laws 20-1073
- Contract: A legal written agreement that becomes binding when signed.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Health care services: means services for the purpose of diagnosing, preventing, alleviating, curing or healing human illness or injury. See Arizona Laws 20-1051
- Health care services organization: means any person that undertakes to conduct one or more health care plans. See Arizona Laws 20-1051
- Person: means any natural or artificial person including individuals, partnerships, associations, providers of health care, trusts, insurers, hospital or medical service corporations or other corporations, prepaid group practice plans, foundations for medical care and health maintenance organizations. See Arizona Laws 20-1051
- United States: includes the District of Columbia and the territories. See Arizona Laws 1-215
B. To the extent that payment for covered expenses has been made under the state program pursuant to title XIX of the social security act for health care items or services furnished to an individual, the state is considered to have acquired the rights of the individual to payment by any other party for those health care items or services. On presentation of proof that the state program pursuant to title XIX of the social security act has paid for covered items or services, the health care services organization shall make payments to the state program pursuant to title XIX of the social security act according to the coverage provided in the evidence of coverage.
C. A health care services organization may not impose on a state agency that has been assigned the rights of an individual who is eligible for medical assistance and who is covered for health benefits from the insurer any requirements that are different from the requirements applicable to an agent or assignee of any other covered individual.
D. A health care services organization shall not cancel or fail to renew the contract of any person based on that person’s eligibility for or enrollment in a program funded under title XIX of the social security act or Title 36, Chapter 29 or 34. Nothing in this section prohibits cancellation or failure to renew for nonpayment of monies due under the contract.