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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
health insurance; reimbursement rates; vaccines
Purpose
Prohibits a health care insurer, beginning January 1, 2027, from reimbursing a health professional at a different rate based on a covered individual's decision to refuse one or more vaccines.
Background
The Department of Insurance and Financial Institutions regulates policies, certificates, evidences of coverage and contracts of insurance that are issued or delivered by health care insurers (A.R.S. § 20-1379).
Health care service reimbursement rates are governed by a complex mix of federal regulation, state policies and private contract negotiations designed to balance cost control with access to care.
The federal Health Insurance Portability and Accountability Act (HIPAA) generally prohibits health care insurers from discriminating on the basis of health factors. Under HIPAA, health factors include eight health status related factors that may not be used to discriminate in health coverage among individuals, such as medical history, evidence of insurability and disability. Provided benefits must be uniformly available to all similarly situated individuals. Any benefits restriction must be uniformly applied and not be directed at individual participants or beneficiaries based on a health factor (29 C.F.R. § 2590.702).
Health professionals include: 1) podiatrists; 2) chiropractors; 3)
dentists; 4) medical physicians and surgeons; 5) naturopathic physicians; 6)
nurses; 7) dispensing opticians;
8) optometrists; 9) osteopathic physicians and surgeons; 10) pharmacists; 11)
physical therapists; 12) psychologists; 13) veterinarians; 14) physician
assistants; 15) radiologic technologists;
16) homeopathic physicians; 17) behavioral health professionals; 18)
occupational therapists;
19) respiratory therapists; 20) acupuncturists; 21) athletic trainers; 22)
massage therapists;
23) nursing care institution administrators;24) assisted living facilities
managers; 25) midwifes; 26) audiologists; and 27) speech pathologists (A.R.S.
§ 32-3201).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Prohibits a health care insurer, beginning January 1, 2027, from reimbursing a health professional at a different rate based on a covered individual's decision to refuse one or more vaccines.
2. Defines terms.
3. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole
· Replaces the prohibition against a health insurer reimbursing a health professional at a different rate based on a covered individual's vaccination status with a prohibition against a health insurer reimbursing a health professional at a different rate based on a covered individual's decision to refuse one or more vaccines.
Senate Action
FIN 2/16/26 DP 4-2-1
Prepared by Senate Research
March 3, 2026
MG/hk