The Arizona Revised Statutes have been updated to include the revised sections from the 57th Legislature, 1st Regular Session. Please note that the next update of this compilation will not take place until after the conclusion of the 57th Legislature, 2nd Regular Session, which convenes in January 2026.
This online version of the Arizona Revised Statutes is primarily maintained for legislative drafting purposes and reflects the version of law that is effective on January 1st of the year following the most recent legislative session. The official version of the Arizona Revised Statutes is published by Thomson Reuters.
13-3730. Unlawful patient brokering; health care enrollee acts; classification; definitions
A. Notwithstanding section 36-2065, it is unlawful for any person, including a health care provider, behavioral health professional, health care institution, sober living home or insurance producer, to offer, pay, solicit or receive any commission, bonus, rebate, kickback or bribe, directly or indirectly, in cash or in kind, or to engage in any split-fee arrangement, in any form whatsoever, in return for either:
1. Referring patients or clients either:
(a) To a sober living home.
(b) From a sober living home to any other health care institution.
2. Accepting or acknowledging the enrollment of a patient or client for substance use disorder services at a sober living home.
B. Except as otherwise expressly allowed by federal law, it is unlawful for a health care provider, health care institution or drug manufacturer to pay, directly or indirectly, the premiums or subscription fees for an enrollee under any health benefits plan issued by a health care insurer in this state.
C. It is unlawful for a person who is licensed or who is required to be licensed as an insurance producer pursuant to title 20 to knowingly provide false or fraudulent information, directly or indirectly through employees or representatives, about a person's eligibility for or enrollment status in the Arizona health care cost containment system in connection with an application for, enrollment in or change in coverage under any health benefits plan issued by a health care insurer in this state.
D. The following are exempt from the limitations and prohibitions set forth in this section if remuneration prohibited by subsection A of this section is not paid or received:
1. Health insurance navigators and certified application counselors who act within the scope of their license or registration in assisting persons with enrollment in a health benefits plan and who do not knowingly provide or facilitate the provision of false or fraudulent information on an application submitted to a health benefit exchange established pursuant to 42 United States Code section 18031(b) or 18041(c).
2. Case management, coordination of care and patient consultation activities that are performed in the ordinary course of business.
E. In addition to any other penalty prescribed by this title, the court shall order a person who is convicted of a violation of this section to pay a civil penalty of not less than $1,000 for each violation of this section. The court shall double the civil penalty if the person is a serial offender.
F. A violation of subsection A, B or C of this section is:
1. A class 3 felony if the consideration has a value of $1,000 or more.
2. A class 4 felony if the consideration has a value of more than $100 but less than $1,000.
3. A class 6 felony if the consideration has a value of $100 or less.
G. For the purposes of this section:
1. "Behavioral health professional" means any person who is regulated pursuant to title 32, chapter 33.
2. "Drug manufacturer" means any person that produces, prepares, compounds, processes, packages, labels, propagates or repackages prescription medication.
3. "Enrollee" means an individual who is a patient of or receiving health care services from, and is not an employee or dependent of an employee of, a health care provider, health care institution or drug manufacturer and who is enrolled in a health benefits plan provided by a health care insurer.
4. "Health benefits plan" means a disability insurance policy, a hospital and medical service corporation policy or certificate, a health care services organization contract, a group disability policy or a certificate of insurance of a group disability policy, including medicare advantage plans, medicare supplement insurance plans and medicare part D prescription drug plans, and the Arizona health care cost containment system health plan.
5. "Health care institution" has the same meaning prescribed in section 36-401.
6. "Health care insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation or a contractor as defined in section 36-2901.
7. "Health care provider" means a person who is regulated pursuant to title 32, chapter 7, 8, 11, 13, 14, 15, 15.1, 16, 17, 18, 19, 19.1, 25, 28, 29, 33, 34, 35, 39 or 41 or title 36, chapter 6, article 7 or chapter 17.
8. "Serial offender" means a person who within a period of ten years has been convicted of two or more violations of this section.
9. "Sober living home" has the same meaning prescribed in section 36-2061.