ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
emergency services; prudent layperson; definition
Purpose
Modifies the definition of emergency services as it applies to health insurance coverage of emergency health care.
Background
For insurance purposes, emergency services are health care services that are provided to an enrollee in a licensed hospital emergency facility by a provider after the recent onset of a medical condition that manifests itself by symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in any of the following: a) serious jeopardy to the patient's health; b) serious impairment to bodily functions; and c) serious dysfunction of any bodily organ or part (A.R.S. § 20-2801).
For public health and safety purposes, emergency health care services is treatment for a medical or behavioral health condition, including labor and delivery, that manifests itself by acute symptoms of sufficient severity, including severe pain, such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in: a) placing the patient's health, including mental health, in serious jeopardy; b) serious impairment to a bodily function of the patient; c) serious dysfunction of any bodily organ or part of the patient; or d) harm to the patient or others (A.R.S. § 36-439).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Includes, in the definition of emergency services, health care services provided:
a) to a health insurance enrollee for the treatment of severe pain, such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention would result in harm, impairment or dysfunction; and
b) for symptoms of sufficient severity that, without immediate medical attention, could result in serious jeopardy to the patient's mental health or harm to the patient or others.
2. Makes technical and conforming changes.
3. Becomes effective on the general effective date.
House Action
HHS 1/29/24 DP 10-0-0-0
3rd Read 2/12/24 57-0-1-0-2
Prepared by Senate Research
February 23, 2024
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