SB 1494

Senate Engrossed
technical
  correction; open pit mining
(now: health insurance; patient steering;
  prohibition)
State of Arizona
Senate
Fifty-seventh Legislature
Second Regular Session
2026
CHAPTER 180
SENATE BILL 1494
AN
ACT
amending sections 13-3730, 20-281,
20-449, 32-1401, 32-1601, 32-1854 and 36-407,
Arizona Revised Statutes; relating to patient brokering.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 13-3730, Arizona Revised
Statutes, is amended to read:
START_STATUTE13-3730. Unlawful patient brokering; health care enrollee acts;
classification; definitions
A. Notwithstanding section 36-2065,
it is unlawful for a  any person, including a health care provider, behavioral
health professional, health care institution, or 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 or from a sober living home. or substance use disorder treatment
facility
(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. END_STATUTE
Sec. 2. Section 20-281, Arizona Revised Statutes, is amended to read:
START_STATUTE20-281. Definitions
In this article, unless the
context otherwise requires:
1. "Business entity" means any
corporation, association, partnership, limited liability company, limited
liability partnership or other legal entity except an individual or sole
proprietorship.
2. "Designated producer" means the
individual insurance producer that a business entity designates pursuant to
section 20-285, subsection C, paragraph 3 as the individual responsible
for the business entity's compliance with the insurance laws of this state.
3. "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.
3. 4. "Health
or sickness insurance" means disability insurance as defined in section 20-253.
4. 5. "Home
state" means the District of Columbia and any state or territory of the
United States in which:
(a) An individual insurance producer maintains a
principal place of residence or principal place of business and is licensed to
act as a resident insurance producer.
(b) A business entity insurance producer maintains
its principal place of business and is licensed to act as a resident insurance
producer.
5. 6. "Insurance
producer" means a person required to be licensed under this article to
sell, solicit or negotiate insurance.
6. 7. "Limited
line credit insurance" means any form of insurance that is offered in
connection with an extension of credit and that is limited to partially or
wholly extinguishing that credit obligation, including credit life, credit disability,
credit property, credit unemployment, involuntary unemployment, mortgage life,
mortgage guaranty, mortgage disability, guaranteed asset or automobile
protection insurance and any other form of insurance that is offered in
connection with an extension of credit, that is limited to partially or wholly
extinguishing that credit obligation and that the director determines should be
designated a form of limited line credit insurance.
7. 8. "Limited
line insurance" means limited line credit insurance, limited line crop
insurance, limited lines travel insurance under section 20-3553 and any
other line of insurance that the director deems necessary to recognize for the
purposes of complying with section 20-287, subsection C, paragraph 2.
8. 9. "Major
line insurance" means life insurance, accident and health or sickness
insurance, property insurance, casualty insurance, personal lines insurance and
variable insurance contracts, as described in section 20-286.
9. 10. "Member"
means, if used in reference to a business entity, a person that holds an
ownership interest in the business entity, excluding any interest in publicly
traded securities and any interest of less than ten percent of the voting
rights.
10. 11. "Negotiate"
means the act of conferring directly with or offering advice directly to a
purchaser or prospective purchaser of a particular contract of insurance
concerning any of the substantive benefits, terms or conditions of the contract
if the person engaged in that act either sells insurance or obtains insurance
from insurers for purchasers.
11. 12. "Nonresident"
means a person whose home state is not Arizona.
12. 13. "Person"
means an individual or a business entity.
13. 14. "Resident"
means a person whose home state is Arizona and who does not hold a resident
insurance producer license in another state or territory of the United States
or in the District of Columbia.
14. 15. "Sell"
means to exchange a contract of insurance by any means, for money or its
equivalent, on behalf of an insurer.
15. 16. "Solicit":
(a) Means
attempting to sell insurance or asking or urging a person to apply for a
particular kind of insurance from a particular company.
(b) includes,
if done as a regular course of dealing or business, steering, advising,
recommending or encouraging persons in this state with a known health condition
to terminate their existing health benefits plan or coverage or to let their existing
health benefits plan or coverage lapse and to purchase a replacement or
alternative health benefits plan or policy from an insurer authorized to
transact insurance in this state. END_STATUTE
Sec. 3. Section 20-449, Arizona Revised
Statutes, is amended to read:
START_STATUTE20-449. Rebates on life or disability insurance; definitions
A. Except as otherwise expressly provided by law, no a person shall not
knowingly permit allow or offer to
make or make any contract of life insurance, life annuity or disability
insurance, or agreement as to such contract other than as plainly expressed in
the contract issued thereon, or pay or allow, or give or offer to pay, allow or
give, directly or indirectly, as an inducement to such insurance or annuity,
any rebate of premiums payable on the contract, or any special favor or
advantage in the dividends or other benefits thereon, or any valuable
consideration or inducement whatever not specified in the contract.� For the purposes of this section, a prohibited rebate includes
payment, directly or indirectly, by a health care provider, health care
institution or drug manufacturer of the premiums or subscription fees for an
enrollee under any health benefits plan issued by a health care insurer in this
state.
B. This section does not prohibit an insurer from
retaining an independent third party to conduct a customer feedback effort
intended to help the insurer improve the quality of its products or services
and to offer an insured business or individual a reasonable incentive to
participate in the feedback effort. An incentive is presumed reasonable if it
does not exceed two hundred dollars $200.
An insurer may not offer, reference or promote an incentive or feedback effort
under this section in connection with an application for or renewal of
insurance coverage. For the purposes of this subsection, "feedback
effort" means activities that are designed to elicit customer perceptions
on a predetermined set of topics that are related to the insurer's products or
services, including in-person, telephonic or online surveys, polls, focus
groups, interviews, questionnaires and other recognized opinion-gathering
mechanisms.
C. For the purposes of this section:
1. "Drug manufacturer"
means any person that produces, prepares, compounds, processes, packages,
labels, propagates or repackages prescription medication.
2. "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.
3. "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.
4. "HEALTH CARE
INSTITUTION" HAS THE SAME MEANING PRESCRIBED IN SECTION 36-401.
5. "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.
6. "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.END_STATUTE
Sec. 4. Section 32-1401, Arizona Revised
Statutes, is amended to read:
START_STATUTE32-1401. Definitions
In this chapter, unless the context otherwise requires:
1. "Active license" means a valid and
existing license to practice medicine.
2. "Adequate records" means legible
medical records, produced by hand or electronically, containing, at a minimum,
sufficient information to identify the patient, support the diagnosis, justify
the treatment, accurately document the results, indicate advice and cautionary
warnings provided to the patient and provide sufficient information for another
practitioner to assume continuity of the patient's care at any point in the
course of treatment.
3. "Advisory letter" means a
nondisciplinary letter to notify a licensee that either:
(a) While there is insufficient evidence to support
disciplinary action, the board believes that continuation of the activities
that led to the investigation may result in further board action against the
licensee.
(b) The violation is a minor or technical violation
that is not of sufficient merit to warrant disciplinary action.
(c) While the licensee has demonstrated substantial
compliance through rehabilitation or remediation that has mitigated the need
for disciplinary action, the board believes that repetition of the activities
that led to the investigation may result in further board action against the
licensee.
4. "Approved hospital internship, residency or
clinical fellowship program" means a program at a hospital that at the
time the training occurred was legally incorporated and that had a program that
was approved for internship, fellowship or residency training by the
accreditation council for graduate medical education, the association of
American medical colleges, the royal college of physicians and surgeons of
Canada or any similar body in the United States or Canada approved by the board
whose function is that of approving hospitals for internship, fellowship or
residency training.
5. "Approved school of medicine" means any
school or college offering a course of study that, on successful completion,
results in the degree of doctor of medicine and whose course of study has been
approved or accredited by an educational or professional association,
recognized by the board, including the association of American medical
colleges, the association of Canadian medical colleges or the American medical
association.
6. "Board" means the Arizona medical
board.
7. "Completed application" means that the
applicant has supplied all required fees, information and correspondence
requested by the board on forms and in a manner acceptable to the board.
8. "Direct supervision" means that a
physician, physician assistant licensed pursuant to chapter 25 of this title or
nurse practitioner certified pursuant to chapter 15 of this title is within the
same room or office suite as the medical assistant in order to be available for
consultation regarding those tasks the medical assistant performs pursuant to
section 32-1456.
9. "Dispense"
means the delivery by a doctor of medicine of a prescription drug or device to
a patient, except for samples packaged for individual use by licensed
manufacturers or repackagers of drugs, and includes the prescribing, administering,
packaging, labeling and security necessary to prepare and safeguard the drug or
device for delivery.
10. "Doctor of medicine" means a natural
person holding a license, registration or permit to practice medicine pursuant
to this chapter.
11. "Full-time faculty member" means
a physician who is employed full time as a faculty member while holding the
academic position of assistant professor or a higher position at an approved
school of medicine.
12. "Health care institution" means any
facility as defined in section 36-401, any person authorized to transact
disability insurance, as defined in title 20, chapter 6, article 4 or 5, any
person who is issued a certificate of authority pursuant to title 20, chapter
4, article 9 or any other partnership, association or corporation that provides
health care to consumers.
13. "Immediate family" means the spouse,
natural or adopted children, father, mother, brothers and sisters of the doctor
of medicine and the natural or adopted children, father, mother, brothers and
sisters of the doctor of medicine's spouse.
14. "Letter of reprimand" means a
disciplinary letter that is issued by the board and that informs the physician
that the physician's conduct violates state or federal law and may require the
board to monitor the physician.
15. "Limit" means taking a nondisciplinary
action that alters the physician's practice or professional activities if the
board determines that there is evidence that the physician is or may be
mentally or physically unable to safely engage in the practice of medicine.
16. "Medical assistant" means an
unlicensed person who meets the requirements of section 32-1456, has
completed an education program approved by the board, assists in a medical
practice under the supervision of a doctor of medicine, physician assistant or
nurse practitioner and performs delegated procedures commensurate with the
medical assistant's education and training but does not diagnose, interpret,
design or modify established treatment programs or perform any functions that
would violate any statute applicable to the practice of medicine.
17. "Medically incompetent" means a person
who the board determines is incompetent based on a variety of factors,
including:
(a) A lack of sufficient medical knowledge or
skills, or both, to a degree likely to endanger the health of patients.
(b) When considered with other indications of
medical incompetence, failing to obtain a scaled score of at least seventy-five
percent on the written special purpose licensing examination.
18. "Medical peer review" means:
(a) The participation by a doctor of medicine in the
review and evaluation of the medical management of a patient and the use of
resources for patient care.
(b) Activities relating to a health care
institution's decision to grant or continue privileges to practice at that
institution.
19. "Medicine" means allopathic medicine
as practiced by the recipient of a degree of doctor of medicine.
20. "Office-based surgery" means a
medical procedure conducted in a physician's office or other outpatient setting
that is not part of a licensed hospital or licensed ambulatory surgical center.
21. "Physician" means a doctor of medicine
who is licensed pursuant to this chapter.
22. "Practice of medicine":
(a) Means the diagnosis, the treatment or the
correction of or the attempt or the claim to be able to diagnose, treat or
correct any and all human diseases, injuries, ailments, infirmities or
deformities, physical or mental, real or imaginary, by any means, methods,
devices or instrumentalities, except as the same may be among the acts or
persons not affected by this chapter.
(b) Includes the practice of medicine alone or the
practice of surgery alone, or both.
23. "Restrict" means taking a disciplinary
action that alters the physician's practice or professional activities if the
board determines that there is evidence that the physician is or may be
medically incompetent or guilty of unprofessional conduct.
24. "Special purpose licensing
examination" means an examination that is developed by the national board
of medical examiners on behalf of the federation of state medical boards for
use by state licensing boards to test the basic medical competence of
physicians who are applying for licensure and who have been in practice for a
considerable period of time in another jurisdiction and to determine the
competence of a physician who is under investigation by a state licensing
board.
25. "Teaching hospital's accredited graduate
medical education program" means that the hospital is incorporated and has
an internship, fellowship or residency training program that is accredited by
the accreditation council for graduate medical education, the American medical
association, the association of American medical colleges, the royal college of
physicians and surgeons of Canada or a similar body in the United States or
Canada that is approved by the board and whose function is that of approving hospitals
for internship, fellowship or residency training.
26. "Teaching license" means a valid
license to practice medicine as a full-time faculty member of an approved
school of medicine or a teaching hospital's accredited graduate medical
education program.
27. "Unprofessional conduct" includes the
following, whether occurring in this state or elsewhere:
(a) Violating any federal or state laws, rules or
regulations applicable to the practice of medicine.
(b) Intentionally disclosing a professional secret
or intentionally disclosing a privileged communication except as either act may
otherwise be required by law.
(c) Committing false, fraudulent, deceptive or
misleading advertising by a doctor of medicine or the doctor of medicine's
staff, employer or representative.
(d) Committing a felony, whether or not involving
moral turpitude, or a misdemeanor involving moral turpitude. In
either case, conviction by any court of competent jurisdiction or a plea of no
contest is conclusive evidence of the commission.
(e) Failing or refusing to maintain adequate records
on a patient.
(f) Exhibiting a pattern of using or being under the
influence of alcohol or drugs or a similar substance while practicing medicine
or to the extent that judgment may be impaired and the practice of medicine
detrimentally affected.
(g) Using controlled substances except if prescribed
by another physician for use during a prescribed course of treatment.
(h) Prescribing or dispensing controlled substances
to members of the physician's immediate family.
(i) Prescribing, dispensing or administering
schedule II controlled substances as prescribed by section 36-2513 or the
rules adopted pursuant to section 36-2513, including amphetamines and
similar schedule II sympathomimetic drugs in the treatment of exogenous obesity
for a period in excess of thirty days in any one year, or the nontherapeutic
use of injectable amphetamines.
(j) Prescribing, dispensing or administering any
controlled substance or prescription-only drug for other than accepted
therapeutic purposes.
(k) Dispensing a
schedule II controlled substance that is an opioid, except as provided in
sections 32-1491 and 32-3248.03.
(l) Signing a blank,
undated or predated prescription form.
(m) Committing conduct that the board determines is
gross malpractice, repeated malpractice or any malpractice resulting in the
death of a patient.
(n) Representing that a manifestly incurable disease
or infirmity can be permanently cured, or that any disease, ailment or
infirmity can be cured by a secret method, procedure, treatment, medicine or
device, if this is not true.
(o) Refusing to divulge to the board on demand the
means, method, procedure, modality of treatment or medicine used in the
treatment of a disease, injury, ailment or infirmity.
(p) Having action taken against a doctor of medicine
by another licensing or regulatory jurisdiction due to that doctor of
medicine's mental or physical inability to engage safely in the practice of
medicine or the doctor of medicine's medical incompetence or for unprofessional
conduct as defined by that jurisdiction and that corresponds directly or
indirectly to an act of unprofessional conduct prescribed by this paragraph.
The action taken may include refusing, denying, revoking or suspending a
license by that jurisdiction or a surrendering of a license to that
jurisdiction, otherwise limiting, restricting or monitoring a licensee by that
jurisdiction or placing a licensee on probation by that jurisdiction.
(q) Having sanctions imposed by an agency of the
federal government, including restricting, suspending, limiting or removing a
person from the practice of medicine or restricting that person's ability to
obtain financial remuneration.
(r) Committing any conduct or practice that is or
might be harmful or dangerous to the health of the patient or the public.
(s) Violating a formal order, probation, consent
agreement or stipulation issued or entered into by the board or its executive
director under this chapter.
(t) Violating or attempting to violate, directly or
indirectly, or assisting in or abetting the violation of or conspiring to
violate any provision of this chapter.
(u) Knowingly making any false or fraudulent
statement, written or oral, in connection with the practice of medicine or if
applying for privileges or renewing an application for privileges at a health
care institution.
(v) Charging a fee for services not rendered or
dividing a professional fee for patient referrals among health care providers
or health care institutions or between these providers and institutions or a
contractual arrangement that has the same effect. This subdivision does not
apply to payments from a medical researcher to a physician in connection with
identifying and monitoring patients for a clinical trial regulated by the
United States food and drug administration.
(w) Obtaining a fee by fraud, deceit or
misrepresentation.
(x) Charging or collecting a clearly excessive
fee. In determining whether a fee is clearly excessive, the board
shall consider the fee or range of fees customarily charged in this state for
similar services in light of modifying factors such as the time required, the
complexity of the service and the skill requisite to perform the service
properly. This subdivision does not apply if there is a clear
written contract for a fixed fee between the physician and the patient that has
been entered into before the provision of the service.
(y) Committing conduct that is in violation of
section 36-2302.
(z) Using experimental forms of diagnosis and
treatment without adequate informed patient consent, and without conforming to
generally accepted experimental criteria, including protocols, detailed
records, periodic analysis of results and periodic review by a medical peer
review committee as approved by the United States food and drug administration
or its successor agency.
(aa) Engaging in sexual conduct with a current
patient or with a former patient within six months after the last medical
consultation unless the patient was the licensee's spouse at the time of the
contact or, immediately preceding the physician-patient relationship, was
in a dating or engagement relationship with the licensee. For the
purposes of this subdivision, "sexual conduct" includes:
(i) Engaging in or soliciting sexual relationships,
whether consensual or nonconsensual.
(ii) Making sexual advances, requesting sexual
favors or engaging in any other verbal conduct or physical contact of a sexual
nature.
(iii) Intentionally viewing a completely or
partially disrobed patient in the course of treatment if the viewing is not
related to patient diagnosis or treatment under current practice standards.
(bb) Procuring or attempting to procure a license to
practice medicine or a license renewal by fraud, by misrepresentation or by
knowingly taking advantage of the mistake of another person or an agency.
(cc) Representing or claiming to be a medical
specialist if this is not true.
(dd) Maintaining a professional connection with or
lending one's name to enhance or continue the activities of an illegal
practitioner of medicine.
(ee) Failing to furnish information in a timely
manner to the board or the board's investigators or representatives if legally
requested by the board.
(ff) Failing to allow properly authorized board
personnel on demand to examine and have access to documents, reports and
records maintained by the physician that relate to the physician's medical
practice or medically related activities.
(gg) Knowingly failing to disclose to a patient on a
form that is prescribed by the board and that is dated and signed by the
patient or guardian acknowledging that the patient or guardian has read and
understands that the doctor has a direct financial interest in a separate
diagnostic or treatment agency or in nonroutine goods or services that the
patient is being prescribed if the prescribed treatment, goods or services are
available on a competitive basis. This subdivision does not apply to a referral
by one doctor of medicine to another doctor of medicine within a group of
doctors of medicine practicing together.
(hh) Using chelation therapy in the treatment of
arteriosclerosis or as any other form of therapy, with the exception of
treatment of heavy metal poisoning, without:
(i) Adequate informed patient consent.
(ii) Conforming to generally accepted experimental
criteria, including protocols, detailed records, periodic analysis of results
and periodic review by a medical peer review committee.
(iii) Approval by the United States food and drug
administration or its successor agency.
(ii) Prescribing, dispensing or administering
anabolic-androgenic steroids to a person for other than therapeutic
purposes.
(jj) Exhibiting a lack of or inappropriate
direction, collaboration or direct supervision of a medical assistant or a
licensed, certified or registered health care provider employed by, supervised
by or assigned to the physician.
(kk) Knowingly making a false or misleading
statement to the board or on a form required by the board or in a written
correspondence, including attachments, with the board.
(ll) Failing to dispense drugs and devices in
compliance with article 6 of this chapter.
(mm) Committing conduct that the board determines is
gross negligence, repeated negligence or negligence resulting in harm to or the
death of a patient.
(nn) Making a representation by a doctor of medicine
or the doctor of medicine's staff, employer or representative that the doctor
of medicine is boarded or board certified if this is not true or the standing
is not current or without supplying the full name of the specific agency,
organization or entity granting this standing.
(oo) Refusing to submit to a body fluid examination
or any other examination known to detect the presence of alcohol or other drugs
as required by the board pursuant to section 32-1452 or pursuant to a
board investigation into a doctor of medicine's alleged substance abuse.
(pp) Failing to report in writing to the Arizona
medical board or the Arizona regulatory board of physician assistants any
evidence that a doctor of medicine or a physician assistant is or may be
medically incompetent, guilty of unprofessional conduct or mentally or
physically unable to safely practice medicine or to perform as a physician
assistant.
(qq) As a physician who is the chief executive
officer, the medical director or the medical chief of staff of a health care
institution, failing to report in writing to the board that the hospital
privileges of a doctor of medicine have been denied, revoked, suspended,
supervised or limited because of actions by the doctor of medicine that appear
to show that the doctor of medicine is or may be medically incompetent, is or
may be guilty of unprofessional conduct or is or may be unable to engage safely
in the practice of medicine.
(rr) Claiming to be a current member of the board or
its staff or a board medical consultant if this is not true.
(ss) Failing to make
patient medical records in the physician's possession promptly available to a
physician assistant, a nurse practitioner, a person licensed pursuant to this
chapter or a podiatrist, chiropractor, naturopathic physician, osteopathic
physician or homeopathic physician licensed under chapter 7, 8, 14, 17 or 29 of
this title on receipt of proper authorization to do so from the patient, a
minor patient's parent, the patient's legal guardian or the patient's
authorized representative or failing to comply with title 12, chapter 13,
article 7.1.
(tt) Prescribing, dispensing or furnishing a
prescription medication or a prescription-only device as defined in
section 32-1901 to a person unless the licensee first conducts a physical
or mental health status examination of that person or has previously
established a doctor-patient relationship. The physical or
mental health status examination may be conducted through telehealth as defined
in section 36-3601 with a clinical evaluation that is appropriate for the
patient and the condition with which the patient presents, unless the
examination is for the purpose of obtaining a written certification from the
physician for the purposes of title 36, chapter 28.1. This
subdivision does not apply to:
(i) A physician who provides temporary patient
supervision on behalf of the patient's regular treating licensed health care
professional or provides a consultation requested by the patient's regular
treating licensed health care professional.
(ii) Emergency medical situations as defined in
section 41-1831.
(iii) Prescriptions written to prepare a patient for
a medical examination.
(iv) Prescriptions written or prescription
medications issued for use by a county or tribal public health department for
immunization programs or emergency treatment or in response to an infectious
disease investigation, public health emergency, infectious disease outbreak or
act of bioterrorism. For the purposes of this item,
"bioterrorism" has the same meaning prescribed in section 36-781.
(v) Prescriptions written or antimicrobials
dispensed to a contact as defined in section 36-661 who is believed to
have had significant exposure risk as defined in section 36-661 with
another person who has been diagnosed with a communicable disease as defined in
section 36-661 by the prescribing or dispensing physician.
(vi) Prescriptions written or prescription
medications issued for administration of immunizations or vaccines listed in
the United States centers for disease control and prevention's recommended
immunization schedule to a household member of a patient.
(vii) Prescriptions for epinephrine delivery systems
that are written or dispensed for a school district or charter school to be
stocked for emergency use pursuant to section 15-157 or for an authorized
entity to be stocked pursuant to section 36-2226.01.
(viii) Prescriptions for glucagon written or
dispensed for a school district or charter school to be stocked for emergency
use pursuant to section 15-344.01.
(ix) Prescriptions written by a licensee through a
telehealth program that is covered by the policies and procedures adopted by
the administrator of a hospital or outpatient treatment center.
(x) Prescriptions for naloxone hydrochloride or any
other opioid antagonist approved by the United States food and drug
administration that are written or dispensed for use pursuant to section 36-2228
or 36-2266.
(uu) Performing office-based surgery using
sedation in violation of board rules.
(vv) Practicing medicine under a false or assumed
name in this state.
(ww) Advising a
patient, whether directly or indirectly through staff, to enroll in or
disenroll from a specific health insurance policy or plan issued by a specific
insurance company unless the licensee or staff member is a licensed insurance
producer in this state. This subdivision does not prohibit or prevent a
licensee from discussing with patients whether the licensee is in network or
out of network with any specific insurance company or under any specific
insurance policy or plan. END_STATUTE
Sec. 5. Section 32-1601, Arizona Revised
Statutes, is amended to read:
START_STATUTE32-1601. Definitions
In this chapter, unless the context otherwise requires:
1. "Absolute discharge from the sentence"
means completion of any sentence, including imprisonment, probation, parole,
community supervision or any form of court supervision.
2. "Appropriate health care professional"
means a licensed health care professional whose scope of practice, education,
experience, training and accreditation are appropriate for the situation or
condition of the patient who is the subject of a consultation or referral.
3. "Approval" means that a regulated
training or educational program to prepare persons for licensure, certification
or registration has met standards established by the board.
4. "Board" means the Arizona state board
of nursing.
5. "Certified nurse midwife" means a
registered nurse who:
(a) Is certified by the board.
(b) Has completed a nurse midwife education program that is approved or recognized by the board and educational
requirements prescribed by the board by rule.
(c) Holds a national certification as a certified
nurse midwife from a national certifying body that is
recognized by the board.
(d) Has an expanded scope of practice in providing
health care services for women from adolescence to beyond menopause, including
antepartum, intrapartum, postpartum, reproductive, gynecologic and primary
care, for normal newborns during the first twenty-eight days of life and
for men for the treatment of sexually transmitted diseases. The expanded scope
of practice under this subdivision includes:
(i) Assessing patients, synthesizing and analyzing
data and understanding and applying principles of health care at an advanced
level.
(ii) Managing the physical and psychosocial health
care of patients.
(iii) Analyzing multiple sources of data,
identifying alternative possibilities as to the nature of a health care problem
and selecting, implementing and evaluating appropriate treatment.
(iv) Making independent decisions in solving complex
patient care problems.
(v) Diagnosing, performing diagnostic and
therapeutic procedures and prescribing, administering and dispensing
therapeutic measures, including legend drugs, medical devices and controlled
substances, within the scope of the certified nurse midwife practice after
meeting requirements established by the board.
(vi) Recognizing the limits of the nurse's
certified nurse midwife's knowledge and experience by
consulting with or referring patients to other appropriate health care
professionals if a situation or condition occurs that is beyond the knowledge
and experience of the certified nurse
midwife or if the referral will protect the health and
welfare of the patient.
(vii) Delegating to a medical assistant pursuant to
section 32-1456.
(viii) Performing additional acts that require
education and training as prescribed by the board and that are recognized by
the nursing profession as proper to be performed by a certified nurse midwife.
6. "Certified nursing assistant" means a
person who is registered on the registry of nursing assistants pursuant to this
chapter to provide or assist in delivering nursing or nursing-related services
under the supervision and direction of a licensed nursing staff
member. Certified nursing assistant does not include a person who:
(a) Is a licensed health care professional.
(b) Volunteers to provide nursing assistant services
without monetary compensation.
(c) Is a licensed nursing assistant.
7. "Certified registered nurse" means a
registered nurse who has been certified by a national nursing credentialing
agency that is recognized by the board.
8. "Certified registered nurse
anesthetist" means a registered nurse who meets the requirements of
section 32-1634.03 and who practices pursuant to the requirements of
section 32-1634.04.
9. "Clinical nurse specialist" means a
registered nurse who:
(a) Is certified by the board as a clinical nurse
specialist.
(b) Holds a graduate degree with a major in nursing
and completes educational requirements as prescribed by the board by rule.
(c) Is nationally certified as a clinical nurse
specialist or, if certification is not available, provides proof of competence
to the board.
(d) Has an expanded
scope of practice based on advanced education in a clinical nursing specialty
that includes:
(i) Assessing
clients, synthesizing and analyzing data and understanding and applying nursing
principles at an advanced level.
(ii) Managing directly and indirectly a client's
physical and psychosocial health status.
(iii) Analyzing multiple sources of data,
identifying alternative possibilities as to the nature of a health care problem
and selecting appropriate nursing interventions.
(iv) Developing, planning and guiding programs of
care for populations of patients.
(v) Making independent nursing decisions to solve
complex client care problems.
(vi) Using research skills and acquiring and
applying critical new knowledge and technologies to nursing practice.
(vii) Prescribing and dispensing durable medical
equipment.
(viii) Consulting with or referring a client to
other health care providers based on assessment of the client's health status
and needs.
(ix) Facilitating collaboration with other
disciplines to attain the desired client outcome across the continuum of care.
(x) Performing additional acts that require
education and training as prescribed by the board and that are recognized by
the nursing profession as proper to be performed by a clinical nurse
specialist.
(xi) Prescribing, ordering and dispensing
pharmacological agents that are subject to the
requirements and limits specified in section 32-1651.
10. "Conditional license" or
"conditional approval" means a license or approval that specifies the
conditions under which the regulated party is allowed to practice or to operate
and that is prescribed by the board pursuant to section 32-1644 or 32-1663.
11. "Delegation" means transferring to a
competent individual the authority to perform a selected nursing task in a
designated situation in which the nurse making the delegation retains
accountability for the delegation.
12. "Disciplinary action" means a
regulatory sanction of a license, certificate or approval pursuant to this
chapter in any combination of the following:
(a) A civil penalty for each violation of this
chapter, not to exceed $1,000 for each violation.
(b) Restitution made to an aggrieved party.
(c) A decree of censure.
(d) A conditional license or a conditional approval
that fixed fixes
a period and terms of probation.
(e) Limited licensure.
(f) Suspension of a license, a certificate or an
approval.
(g) Voluntary surrender of a license, a certificate
or an approval.
(h) Revocation of a license, a certificate or an
approval.
13. "Health care institution" has the same
meaning prescribed in section 36-401.
14. "Licensed health aide" means a person
who:
(a) Is licensed pursuant to this chapter to provide
or to assist in providing nursing-related services authorized pursuant to
section 36-2939.
(b) Is the parent, guardian or family member by
affinity or consanguinity of the Arizona long-term care system member
receiving services who may provide licensed health aide services only to that
member and only consistent with that member's plan of care.
(c) Has a scope of practice that is the same as a
licensed nursing assistant and may also provide medication administration,
tracheostomy care, enteral care and routine ventilator care and therapy and any
other tasks approved by the board in rule.
(d) Has supervision requirements that are the same
as a certified nursing assistant.
15. "Licensed nursing assistant" means a
person who is licensed pursuant to this chapter to provide or assist in
delivering nursing or nursing-related services under the supervision and
direction of a licensed nursing staff member. Licensed nursing
assistant does not include a person who:
(a) Is a licensed health care professional.
(b) Volunteers to provide nursing assistant services
without monetary compensation.
(c) Is a certified nursing assistant.
16. "Licensee" means a person who is
licensed pursuant to this chapter or in a party state as defined in section 32-1668.
17. "Limited license" means a license that
restricts the scope or setting of a licensee's practice.
18. "Medication order" means a written or
verbal communication given by a certified registered nurse anesthetist to a
health care professional to administer a drug or medication, including
controlled substances.
19. "Practical nurse" means a person who holds a
practical nurse license issued pursuant to this chapter or pursuant to a
multistate compact privilege and who practices practical nursing as
defined in this section.
20. "Practical nursing" includes the
following activities that are performed under the supervision of a physician or
a registered nurse:
(a) Contributing to the assessment of the health
status of individuals and groups.
(b) Participating in the development and
modification of the strategy of care.
(c) Implementing aspects of the strategy of care
within the nurse's scope of practice.
(d) Maintaining safe and effective nursing care that
is rendered directly or indirectly.
(e) Participating in the evaluation of responses to
interventions.
(f) Delegating nursing activities within the scope
of practice of a practical nurse.
(g) Performing additional acts that require
education and training as prescribed by the board and that are recognized by
the nursing profession as proper to be performed by a practical nurse.
21. "Presence" means within the same
health care institution or office as specified in section 32-1634.04,
subsection A,  and available as necessary.
22. "Registered nurse" or
"professional nurse" means a person who practices registered nursing
and who holds a registered nurse license issued pursuant to this chapter or
pursuant to a multistate compact privilege.
23. "Registered nurse practitioner" means
a registered nurse who:
(a) Is certified by the board.
(b) Has completed a nurse practitioner education
program that is approved or recognized by the board and
educational requirements prescribed by the board by rule.
(c) If applying for certification after July 1,
2004, holds national certification as a nurse practitioner from a national
certifying body that is recognized by the board.
(d) Has an expanded scope of practice within a
specialty area that includes:
(i) Assessing clients, synthesizing and analyzing
data and understanding and applying principles of health care at an advanced
level.
(ii) Managing the physical and psychosocial health
status of patients.
(iii) Analyzing multiple sources of data,
identifying alternative possibilities as to the nature of a health care problem
and selecting, implementing and evaluating appropriate treatment.
(iv) Making independent decisions in solving complex
patient care problems.
(v) Diagnosing, performing diagnostic and
therapeutic procedures, and prescribing, administering and dispensing
therapeutic measures, including legend drugs, medical devices and controlled substances
within the scope of registered nurse practitioner practice on meeting the
requirements established by the board.
(vi) Recognizing the limits of the nurse's registered nurse practitioner's
knowledge and experience by consulting with or referring patients to other
appropriate health care professionals if a situation or condition occurs that
is beyond the knowledge and experience of the registered nurse practitioner or if the
referral will protect the health and welfare of the patient.
(vii) Delegating to a medical assistant pursuant to
section 32-1456.
(viii) Performing additional acts that require
education and training as prescribed by the board and that are recognized by
the nursing profession as proper to be performed by a registered
nurse practitioner.
24. "Registered nursing" includes the
following:
(a) Diagnosing and treating human responses to
actual or potential health problems.
(b) Assisting individuals and groups to maintain or
attain optimal health by implementing a strategy of care to accomplish defined
goals and evaluating responses to care and treatment.
(c) Assessing the health status of individuals and
groups.
(d) Establishing a nursing diagnosis.
(e) Establishing goals to meet identified health
care needs.
(f) Prescribing nursing interventions to implement a
strategy of care.
(g) Delegating nursing interventions to others who
are qualified to do so.
(h) Providing for the maintenance of safe and
effective nursing care that is rendered directly or indirectly.
(i) Evaluating responses to interventions.
(j) Teaching nursing knowledge and skills.
(k) Managing and supervising the practice of
nursing.
(l) Consulting and coordinating with other health
care professionals in the management of health care.
(m) Performing additional acts that require
education and training as prescribed by the board and that are recognized by
the nursing profession as proper to be performed by a registered nurse.
25. "Registry of nursing assistants" means
the nursing assistants registry maintained by the board pursuant to the omnibus
budget reconciliation act of 1987 (P.L. 100-203; 101 Stat. 1330), as
amended by the medicare catastrophic coverage act of 1988 (P.L. 100-360;
102 Stat. 683).
26. "Regulated party" means any person or
entity that is licensed, certified, registered, recognized or approved pursuant
to this chapter.
27. "Unprofessional conduct" includes the
following, whether occurring in this state or elsewhere:
(a) Committing fraud or deceit in obtaining,
attempting to obtain or renewing a license or a certificate issued pursuant to
this chapter.
(b) Committing a felony, whether or not involving
moral turpitude, or a misdemeanor involving moral turpitude. In
either case, conviction by a court of competent jurisdiction or a plea of no
contest is conclusive evidence of the commission.
(c) Aiding or abetting in a criminal abortion or
attempting, agreeing or offering to procure or assist in a criminal abortion.
(d) Engaging in any conduct or
practice that is or might be harmful or dangerous to the health of a patient or
the public.
(e) Being mentally incompetent or physically unsafe
to a degree that is or might be harmful or dangerous to the health of a patient
or the public.
(f) Having a license, certificate, permit or registration
to practice a health care profession denied, suspended, conditioned, limited or
revoked in another jurisdiction and not reinstated by that jurisdiction.
(g) Wilfully or repeatedly violating a provision of
this chapter or a rule adopted pursuant to this chapter.
(h) Committing an act that deceives, defrauds or
harms the public.
(i) Failing to comply with a stipulated agreement,
consent agreement or board order.
(j) Violating this chapter or a rule that is adopted
by the board pursuant to this chapter.
(k) Failing to report to the board any evidence that
a registered or nurse, practical
nurse or a  nursing assistant is or may be:
(i) Incompetent to practice.
(ii) Guilty of unprofessional conduct.
(iii) Mentally or physically unable to safely
practice nursing or to perform nursing-related duties. A nurse who is
providing therapeutic counseling for a nurse who is in a drug rehabilitation
program is required to report that nurse only if the nurse providing
therapeutic counseling has personal knowledge that patient safety is being jeopardized.
(l) Failing to self-report a conviction for a
felony or undesignated offense within ten days after the conviction.
(m) Cheating or assisting another to cheat on a
licensure or certification examination.
(n) Advising a
patient, whether directly or indirectly through staff, to enroll in or
disenroll from a specific health insurance policy or plan issued by a specific
insurance company unless the licensee or staff member is a licensed insurance
producer in this state. This subdivision does not prohibit or prevent a
licensee from discussing with patients whether the licensee is in network or
out of network with any specific insurance company or under any specific
insurance policy or plan. END_STATUTE
Sec. 6. Section 32-1854, Arizona Revised
Statutes, is amended to read:
START_STATUTE32-1854. Definition of unprofessional conduct
For the purposes of this chapter, "unprofessional
conduct" includes the following acts, whether occurring in this state or
elsewhere:
1. Knowingly betraying a professional secret or
wilfully violating a privileged communication except as either of these may
otherwise be required by law. This paragraph does not prevent
members of the board from exchanging information with the licensing and
disciplinary boards of other states, territories or districts of the United
States or with foreign countries or with osteopathic medical organizations
located in this state or in any state, district or territory of this country or
in any foreign country.
2. Committing a felony or a misdemeanor involving
moral turpitude. In either case conviction by any court of competent
jurisdiction is conclusive evidence of the commission of the offense.
3. Practicing medicine while under the influence of
alcohol, a dangerous drug as defined in section 13-3401, narcotic or
hypnotic drugs or any substance that impairs or may impair the licensee's
ability to safely and skillfully practice medicine.
4. Being diagnosed by a physician licensed under
this chapter or chapter 13 of this title or a psychologist licensed under
chapter 19.1 of this title as excessively or illegally using alcohol or a
controlled substance.
5. Prescribing, dispensing or administering
controlled substances or prescription-only drugs for other than accepted
therapeutic purposes.
6. Engaging in the practice of medicine in a manner
that harms or may harm a patient or that the board determines falls below the
community standard.
7. Impersonating another physician.
8. Acting or assuming to act as a member of the
board if this is not true.
9. Procuring, renewing or attempting to procure or
renew a license to practice osteopathic medicine by fraud or misrepresentation.
10. Having professional connection with or lending
one's name to an illegal practitioner of osteopathic medicine or any of the
other healing arts.
11. Representing that a manifestly incurable
disease, injury, ailment or infirmity can be permanently cured or that a
curable disease, injury, ailment or infirmity can be cured within a stated time
if this is not true.
12. Failing to reasonably disclose and inform the
patient or the patient's representative of the method, device or
instrumentality the licensee uses to treat the patient's disease, injury,
ailment or infirmity.
13. Refusing to divulge to the board on demand the
means, method, device or instrumentality used to treat a disease, injury,
ailment or infirmity.
14. Charging a fee for services not rendered or
dividing a professional fee for patient referrals. This paragraph does not
apply to payments from a medical researcher to a physician in connection with
identifying and monitoring patients for clinical trial regulated by the United
States food and drug administration.
15. Knowingly making any false or fraudulent
statement, written or oral, in connection with the practice of medicine or when
applying for or renewing privileges at a health care institution or a health
care program.
16. Advertising in a false, deceptive or misleading
manner.
17. Representing or claiming to be an osteopathic
medical specialist if the physician has not satisfied the applicable
requirements of this chapter or board rules.
18. Having a license denied or disciplinary action
taken against a license by any other state, territory, district or country,
unless it can be shown that this occurred for reasons that did not relate to
the person's ability to safely and skillfully practice osteopathic medicine or
to any act of unprofessional conduct as provided in this section.
19. Committing any conduct or practice contrary to
recognized standards of ethics of the osteopathic medical profession.
20. Violating or attempting to violate, directly or
indirectly, or assisting in or abetting the violation of or conspiring to
violate any of the provisions of this chapter.
21. Failing or refusing to establish and maintain
adequate records on a patient as follows:
(a) If the patient is an adult, for at least six
years after the last date the licensee provided the patient with medical or
health care services.
(b) If the patient is a child, either for at least
three years after the child's eighteenth birthday or for at least six years
after the last date the licensee provided that patient with medical or health
care services, whichever date occurs later.
22. Using controlled substances or prescription-only
drugs unless they are provided by a medical practitioner, as defined in section
32-1901, as part of a lawful course of treatment.
23. Prescribing controlled substances to members of
one's immediate family unless there is no other physician available within
fifty miles to treat a member of the family and an emergency exists.
24. Committing nontherapeutic use of injectable
amphetamines.
25. Violating a formal order, probation or a
stipulation issued by the board under this chapter.
26. Charging or collecting an inappropriate
fee. This paragraph does not apply to a fee that is fixed in a
written contract between the physician and the patient and entered into before
treatment begins.
27. Using experimental forms of therapy without
adequate informed patient consent or without conforming to generally accepted
criteria and complying with federal and state statutes and regulations
governing experimental therapies.
28. Failing to make patient medical records in the
physician's possession promptly available to a physician assistant, a nurse
practitioner, a person licensed pursuant to this chapter or a podiatrist,
chiropractor, naturopathic physician, physician or homeopathic physician
licensed under chapter 7, 8, 13, 14 or 29 of this title on receipt of proper
authorization to do so from the patient, a minor patient's parent, the
patient's legal guardian or the patient's authorized representative or failing
to comply with title 12, chapter 13, article 7.1.
29. Failing to allow properly authorized board
personnel to have, on presentation of a subpoena, access to any documents,
reports or records that are maintained by the physician and that relate to the
physician's medical practice or medically related activities pursuant to
section 32-1855.01.
30. Signing a blank, undated or predated
prescription form.
31. Obtaining a fee by fraud, deceit or
misrepresentation.
32. Failing to report to the board an osteopathic
physician and surgeon who is or may be guilty of unprofessional conduct or is
or may be mentally or physically unable safely to engage in the practice of
medicine.
33. Referring a
patient to a diagnostic or treatment facility or prescribing goods and services
without disclosing that the physician has a direct pecuniary interest in the
facility, goods or services to which the patient has been referred or prescribed.
This paragraph does not apply to a referral by one physician to another
physician within a group of physicians practicing together.
34. Exhibiting a lack of or inappropriate direction,
collaboration or supervision of a licensed, certified or registered health care
provider or office personnel employed by or assigned to the physician in the
medical care of patients.
35. Violating a federal law, a state law or a rule
applicable to the practice of medicine.
36. Prescribing or dispensing controlled substances
or prescription-only medications without establishing and maintaining
adequate patient records.
37. Dispensing a schedule II controlled substance
that is an opioid, except as provided in sections 32-1871 and 32-3248.03.
38. Failing to dispense drugs and devices in
compliance with article 4 of this chapter.
39. Committing any conduct or practice that
endangers a patient's or the public's health or may reasonably be expected to
do so.
40. Committing any conduct or practice that impairs
the licensee's ability to safely and skillfully practice medicine or that may
reasonably be expected to do so.
41. With the exception of heavy metal poisoning,
using chelation therapy in the treatment of arteriosclerosis or as any other
form of therapy without adequate informed patient consent and without
conforming to generally accepted experimental criteria, including protocols,
detailed records, periodic analysis of results and periodic review by a medical
peer review committee.
42. Prescribing, dispensing or administering
anabolic-androgenic steroids to a person for other than therapeutic
purposes.
43. Engaging in sexual conduct with a current
patient or with a former patient within six months after the last medical consultation
unless the patient was the licensee's spouse at the time of the contact or,
immediately preceding the physician-patient relationship, was in a dating
or engagement relationship with the licensee. For the purposes of this
paragraph, "sexual conduct includes:
(a) Engaging in or soliciting sexual relationships,
whether consensual or nonconsensual.
(b) Making sexual advances, requesting sexual favors
or engaging in any other verbal conduct or physical conduct of a sexual nature.
44. Committing conduct that is in violation of
section 36-2302.
45. Committing conduct that the board determines
constitutes gross negligence, repeated negligence or negligence that results in
harm or death of a patient.
46. Committing conduct in the practice of medicine
that evidences unfitness to practice medicine.
47. Engaging in disruptive or abusive behavior in a
professional setting.
48. Failing to disclose to a patient that the
licensee has a direct financial interest in a prescribed treatment, good or
service if the treatment, good or service is available on a competitive
basis. This paragraph does not apply to a referral by one licensee
to another licensee within a group of licensees who practice together. A
licensee meets the disclosure requirements of this paragraph if both of the
following are true:
(a) The licensee makes the disclosure on a form
prescribed by the board.
(b) The patient or the patient's guardian or parent
acknowledges by signing the form that the licensee has disclosed the licensee's
direct financial interest.
49. Prescribing, dispensing or furnishing a
prescription medication or a prescription-only device to a person if the
licensee has not conducted a physical or mental health status examination of
that person or has not previously established a physician-patient
relationship. The physical or mental health status examination may
be conducted through telehealth as defined in section 36-3601 with a
clinical evaluation that is appropriate for the patient and the condition with
which the patient presents, unless the examination is for the purpose of
obtaining a written certification from the physician for the purposes of title
36, chapter 28.1. This paragraph does not apply to:
(a) Emergencies.
(b) A licensee who provides patient care on behalf
of the patient's regular treating licensed health care professional or provides
a consultation requested by the patient's regular treating licensed health care
professional.
(c) Prescriptions written or antimicrobials
dispensed to a contact as defined in section 36-661 who is believed to
have had significant exposure risk as defined in section 36-661 with
another person who has been diagnosed with a communicable disease as defined in
section 36-661 by the prescribing or dispensing physician.
(d) Prescriptions for epinephrine delivery systems
that are written or dispensed for a school district or charter school to be
stocked for emergency use pursuant to section 15-157 or for an authorized
entity to be stocked pursuant to section 36-2226.01.
(e) Prescriptions for glucagon written or dispensed
for a school district or charter school to be stocked for emergency use
pursuant to section 15-344.01.
(f) Prescriptions written by a licensee through a
telehealth program that is covered by the policies and procedures adopted by
the administrator of a hospital or outpatient treatment center.
(g) Prescriptions for naloxone hydrochloride or any
other opioid antagonist approved by the United States food and drug
administration that are written or dispensed for use pursuant to section 36-2228
or 36-2266.
50. If a licensee provides medical care by computer,
failing to disclose the licensee's license number and the board's address and
telephone number.
51. Advising a patient, whether
directly or indirectly through staff, to enroll in or disenroll from a specific
health insurance policy or plan issued by a specific insurance company unless
the licensee or staff member is a licensed insurance producer in this state.
This paragraph does not prohibit or prevent a licensee from discussing with
patients whether the licensee is in network or out of network with any specific
insurance company or under any specific insurance policy or plan. END_STATUTE
Sec. 7. Section 36-407, Arizona Revised
Statutes, is amended to read:
START_STATUTE36-407. Prohibited acts; required acts
A. A person shall not establish, conduct or maintain
in this state a health care institution or any class or subclass of health care
institution unless that person holds a current and valid license issued by the
department specifying the class or subclass of health care institution the
person is establishing, conducting or maintaining. The license is
valid only for the establishment, operation and maintenance of the class or
subclass of health care institution, the type of services and, except for
emergency admissions as prescribed by the director by rule, the licensed
capacity specified by the license.
B. The licensee shall not imply by advertising,
directory listing or otherwise that the licensee is authorized to perform
services more specialized or of a higher degree of care than is authorized by
this chapter and the underlying rules for the particular class or subclass of
health care institution within which the licensee is licensed.
C. The licensee may not transfer or assign the
license. A license is valid only for the premises occupied by the institution
at the time of its issuance.
D. The licensee shall not personally or through an
agent offer or imply an offer of rebate or fee splitting to any person
regulated by title 32 or chapter 17 of this title.
E. The licensee shall not advise a
patient, whether directly or indirectly through staff, to enroll in or
disenroll from a specific health insurance policy or plan issued by a specific
insurance company unless the licensee or staff member is a licensed insurance
producer in this state. This subsection does not:
1. Prohibit or prevent a licensee
from discussing with patients whether the licensee is in network or out of
network with any specific insurance company or under any specific insurance
policy or plan.
2. Prohibit or prevent health
insurance navigators or certified application counselors acting within the
scope of their license or registration from assisting persons with enrollment
in a health insurance policy or plan.
E. F. The licensee
shall submit an itemized statement of charges to each patient.
F. G. A health care
institution shall refer a patient who is discharged after receiving emergency
services for a drug-related overdose to a behavioral health services
provider.END_STATUTE
APPROVED BY THE GOVERNOR JUNE 19, 2026.
FILED IN THE OFFICE OF THE SECRETARY OF STATE JUNE 22, 2026.