An Act to amend 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g) and 185.983 (1) (intro.); to create 609.825 and 632.851 of the statutes; Relating to: coverage and reimbursement of emergency ambulance services under health insurance policies and plans. (FE)
Impact
This legislation impacts state laws governing health insurance policies by requiring that all defined network plans, preferred provider plans, and self-insured governmental plans cover emergency ambulance services, regardless of whether the provider is a participating provider. The bill stipulates that the reimbursement to these ambulance service providers can either be mutually agreed upon, approved by a local governmental entity, or set at a rate not exceeding 350% of the Medicare published rate, thereby providing multiple avenues for fair compensation.
Summary
Senate Bill 711 focuses on establishing clear guidelines for the coverage and reimbursement of emergency ambulance services under various health insurance policies. The bill mandates that plans offering coverage for emergency medical services must reimburse ambulance service providers at specified rates, ensuring consistency and fairness across different service providers. This includes provisions for how non-participating ambulance service providers can be compensated, with an emphasis on protecting consumers from excessive out-of-pocket costs related to emergency services.
Contention
Notable legislative discussions around SB711 have highlighted potential points of contention regarding cost-sharing measures. The bill explicitly prohibits ambulance providers from billing enrollees for additional costs beyond standard copayments, coinsurance, or deductibles. However, concerns may arise regarding the adequacy of proposed reimbursement rates and their sufficiency to cover the rising costs associated with providing ambulance services. Additionally, there may be debates about the implications of these regulations on service availability and the operations of ambulance providers.
Additional_results
The bill includes time-sensitive provisions that require health insurance policies to address claims for emergency services within a specified timeframe, aiming to streamline payment processes. This legislative effort reveals an intent to balance the needs of healthcare providers with consumer protections, ensuring that emergency medical services are accessible and affordable when they are most needed.
Crossfiled
An Act to amend 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g) and 185.983 (1) (intro.); to create 609.825 and 632.851 of the statutes; Relating to: coverage and reimbursement of emergency ambulance services under health insurance policies and plans. (FE)
Reimbursement of maternal mental health screenings under the Medical Assistance program and coverage of maternal mental health screenings by health insurance policies and plans. (FE)