2017 Arizona Revised Statutes
Title 36 - Public Health and Safety
§ 36-2411 Custom orthotic and custom prosthetic devices; requirements; definition
36-2411. Custom orthotic and custom prosthetic devices; requirements; definition
A. Beginning January 1, 2018, a custom orthotic or custom prosthetic device furnished to an individual shall meet all of the following requirements:
1. Except for a custom orthotic or custom prosthetic device provided by a health care provider who is licensed pursuant to title 32, chapter 7, 13, 17, 19, 25 or 34, be provided by a fabricator or supplier that is accredited by an independent accreditation organization approved by the secretary of the United States department of health and human services pursuant to 42 United States Code section 1395m(a)(20)(B) and the regulations promulgated thereunder.
2. Be provided by a health care provider that is a qualified practitioner as defined in 42 United States Code section 1395m(h)(1)(F) or is licensed pursuant to title 32, chapter 7, 13, 17, 19, 25 or 34.
3. Have a valid prescription for the custom orthotic or custom prosthetic device.
B. Except for a custom orthotic or custom prosthetic device provided by a health care provider who is licensed pursuant to title 32, chapter 7, 13, 17, 19, 25 or 34, a health care provider that does not receive insurance payment for a custom orthotic or custom prosthetic device because the custom orthotic or custom prosthetic device or the provider does not meet the requirements of subsection A of this section may not attempt to collect payment or reimbursement for the amount of the coverage denial for the custom orthotic or custom prosthetic device from the patient. This subsection applies only if the coverage denial is strictly based on the custom orthotic or custom prosthetic device or the provider not meeting the requirements of subsection A of this section.
C. This section does not require a health care provider to accept medicare patients.
D. For the purposes of this section, " custom orthotic or custom prosthetic device" means an orthotic or prosthetic device that is individually fabricated for a patient over a positive mold, a tracing or a scan of the patient. Custom orthotic or custom prosthetic device does not include shoes and shoe inserts, a dental device, a hearing-related device or the replacement of all or part of an internal body organ.
