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What happens when your network gets leased?

Arizona law requires insurers to notify providers

May 13, 2019

By Jennifer Garvin

Phoenix, Ariz. — A new law here requires health insurers to notify contracted providers if their network has been leased to another insurer making Arizona the 17th state to adopt this type of legislation.

The legislation also stipulates that providers may continue with the lease arrangement, opt out of it entirely or enter into a contract directly with the new insurer.

The law prohibits claim payment arrangements where the only acceptable payment method is a credit card payment. It also requires insurers to notify providers of fees associated with claims payments and instructs providers on alternative payment methods. It does allow a fee under certain circumstances if the provider consents to the fee.

Arizona HB 2494 was signed by Gov. Doug Ducey on April 26 and goes into effect in 2020. The bill’s primary sponsor was Dr. Regina Cobb, who represents Arizona’s 5th legislative district and is a former member of the ADA Council on Government Affairs.

“I have personally been a victim of the abuse of the virtual credit card acceptance,” Dr. Cobb said. “I also have experienced signing on as an insurance provider and then forced to take a lower fee from another insurance that I had not signed on to be a provider. The large umbrella insurance purchased a smaller insurance company and underhandedly now forces the new contract on the health care provider. HB 2494 addresses both of these issues.  

“As dentists we provide a great product at a fair price and need to be reimbursed for our efforts. We have many challenges ahead of us but this is just another success to make [the] work day more productive.”

According to the bill’s summary, this law helps establish the “statutory framework regarding electronic funds transfer payments and virtual credit card payment methods between a health care provider and a health insurer.”