§ 20-1051 Definitions
§ 20-1052 Establishment of health care services organizations
§ 20-1052.01 Establishment of provider sponsored health care services organizations; rules; limitations
§ 20-1053 Application for certificate of authority
§ 20-1054 Issuance of certificate of authority
§ 20-1055 Deposit requirement
§ 20-1057 Evidence of coverage by health care services organizations; renewability; definitions
§ 20-1057.01 Standing referrals to network health care professionals; definition
§ 20-1057.02 Prescription drug formulary; definitions
§ 20-1057.03 Chiropractic care; definitions
§ 20-1057.04 Continuity of care; definition
§ 20-1057.05 Medical supplies
§ 20-1057.06 Prior authorization
§ 20-1057.07 Health care services organizations; clinical trials; cancer; definitions
§ 20-1057.08 Prescription contraceptive drugs and devices; definition
§ 20-1057.09 Health care services organizations; varying copayments and deductibles allowed
§ 20-1057.10 Eosinophilic gastrointestinal disorder; formula
§ 20-1057.11 Health care services organizations; autism spectrum disorder; coverage; exceptions; definitions
§ 20-1057.12 Contracts; dentists; covered services; definition
§ 20-1057.13 Telehealth; coverage of health care services; definition
§ 20-1057.14 Cancer treatment medications; cost sharing; definition
§ 20-1057.15 Prescriptions; cost sharing; refills; dispensing fees; definition
§ 20-1057.16 Prescription eyedrops; refills
§ 20-1057.17 Coverage of health care services
§ 20-1057.18 Contracts; optometrists; covered services; definition
§ 20-1057.19 Biomarker testing; coverage; definitions
§ 20-1058 Examination of health care services organizations
§ 20-1059 Annual report to director
§ 20-1059.01 Admitted assets; health care delivery assets
§ 20-1060 Taxes; exemption
§ 20-1061 Prohibited practices; definition
§ 20-1062 Regulation of agents
§ 20-1063 Powers of insurers and hospital and medical service corporations
§ 20-1064 Examination
§ 20-1065 Suspension or revocation of certificate of authority; civil penalties
§ 20-1066 Rehabilitation, liquidation or conservation of health maintenance organization
§ 20-1068 Statutory construction and relationship to other laws
§ 20-1069.01 Right to open enrollment period; enrollees; definitions
§ 20-1070 Acquisitions and mergers
§ 20-1071 Prohibition against excluding coverage because of previous tests for a condition
§ 20-1072 Nonliability of enrollees for provider or hospital charges; penalty
§ 20-1073 Eligibility; prohibiting cancellation because of eligibility for certain benefits
§ 20-1074 Contract termination; duty to report; provision for continued services during insolvency; definitions
§ 20-1075 Transactions with affiliates
§ 20-1077 Use of freestanding urgent care centers; policies
§ 20-1078 Rules
§ 20-1079 Individual health insurance policies; mandatory coverage exemption; definitions

Terms Used In Arizona Laws > Title 20 > Chapter 4 > Article 9 - Health Care Services Organizations

  • Action: includes any matter or proceeding in a court, civil or criminal. See Arizona Laws 1-215
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Balanced budget: A budget in which receipts equal outlays.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • department: means the department of insurance and financial institutions. See Arizona Laws 20-101
  • Dependent: A person dependent for support upon another.
  • Enrollee: means an individual who has been enrolled in a health care plan. See Arizona Laws 20-1051
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Evidence of coverage: means any certificate, agreement or contract issued to an enrollee and setting out the coverage to which the enrollee is entitled. See Arizona Laws 20-1051
  • Fraud: Intentional deception resulting in injury to another.
  • Genetic information: means information about genes, gene products and inherited characteristics that may derive from the individual or a family member, including information regarding carrier status and information derived from laboratory tests that identify mutations in specific genes or chromosomes, physical medical examinations, family histories and direct analysis of genes or chromosomes. See Arizona Laws 20-1051
  • Health care plan: means any contractual arrangement whereby any health care services organization undertakes to provide directly or to arrange for all or a portion of contractually covered health care services and to pay or make reimbursement for any remaining portion of the health care services on a prepaid basis through insurance or otherwise. See Arizona Laws 20-1051
  • Health care services: means services for the purpose of diagnosing, preventing, alleviating, curing or healing human illness or injury. See Arizona Laws 20-1051
  • Health care services organization: means any person that undertakes to conduct one or more health care plans. See Arizona Laws 20-1051
  • Health status-related factor: means any factor in relation to the health of the individual or a dependent of the individual enrolled or to be enrolled in a health care services organization including:

    (a) Health status. See Arizona Laws 20-1051

  • including: means not limited to and is not a term of exclusion. See Arizona Laws 1-215
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Month: means a calendar month unless otherwise expressed. See Arizona Laws 1-215
  • Network plan: means health care services that are provided by a health care services organization under which the financing and delivery of health care services are provided, in whole or in part, through a defined set of providers under contract with the health care services organization. See Arizona Laws 20-1051
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Person: means any natural or artificial person including individuals, partnerships, associations, providers of health care, trusts, insurers, hospital or medical service corporations or other corporations, prepaid group practice plans, foundations for medical care and health maintenance organizations. See Arizona Laws 20-1051
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Process: means a citation, writ or summons issued in the course of judicial proceedings. See Arizona Laws 1-215
  • Provider: means any physician, hospital or other person that is licensed or otherwise authorized to furnish health care services in this state. See Arizona Laws 20-1051
  • Provider sponsored health care services organization: means a provider sponsored organization that provides at least one health care plan only to medicare beneficiaries under the medicare-plus-choice program established under the balanced budget act of 1997 (42 United States Code §§ 1395w-21 through 1395w-28 and title XVIII, part C of the social security act, sections 1851 through 1859). See Arizona Laws 20-1051
  • Provider sponsored organization: means an entity that:

    (a) Is a legal aggregation of providers that operate collectively to provide health care services to medicare beneficiaries under the medicare-plus-choice program established under the balanced budget act of 1997 (42 United States Code §§ 1395w-21 through 1395w-28 and title XVIII, part C of the social security act, sections 1851 through 1859). See Arizona Laws 20-1051

  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Trustee: A person or institution holding and administering property in trust.
  • United States: includes the District of Columbia and the territories. See Arizona Laws 1-215
  • Writing: includes printing. See Arizona Laws 1-215