Senate Engrossed

AHCCCS; claims review; behavioral health

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SENATE BILL 1116

AN ACT

Amending title 36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36-2903.18; 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 36-2903.18, to read:

START_STATUTE36-2903.18. Behavioral health claims; American Indian health program; appeal review requirement

Before Any CLAIM DENIAL OR ADVERSE appeal DETERMINATION BASED ON THE MEDICAL NECESSITY of a behavioral health SERVICE COVERED BY THE american Indian health program, THE CLAIM AND SUPPORTING MEDICAL RECORD DOCUMENTATION shall be reviewed AND THE DENIAL OR ADVERSE DETERMINATION APPROVED by an individual who has AT LEAST TWO YEARS OF relevant clinical experience PROVIDING THE SAME OR SIMILAR SERVICES TO THE SERVICES AT ISSUE. END_STATUTE