Bill

Bill > H0639


FL H0639

FL H0639
Coverage of Out-of-network Ground Ambulance Emergency Services


summary

Introduced
11/21/2023
In Committee
02/07/2024
Crossed Over
Passed
Dead
03/08/2024

Introduced Session

2024 Regular Session

Bill Summary

An act relating to coverage for out-of-network ground ambulance emergency services; creating ss. 627.42398 and 641.31078, F.S.; defining terms; requiring health insurers and health maintenance organizations, respectively, to reimburse out-of-network ambulance service providers at specified rates for providing emergency services; specifying that such payment is payment in full; providing exceptions; prohibiting cost-sharing responsibilities paid for an out-of- network ambulance service provider from exceeding those of an in-network ambulance service provider for covered services; requiring health insurers and health maintenance organizations, respectively, to remit payment for covered services if such transportation was requested by a first responder or a health care professional; providing procedures for claims; providing an effective date.

AI Summary

This bill requires health insurers and health maintenance organizations (HMOs) to reimburse out-of-network ground ambulance service providers for emergency services at specified rates, which are the lesser of the local government-set rate, 350% of the Medicare rate, or the in-network contracted rate. The payment is considered full payment, and the provider cannot bill the enrollee/subscriber for any additional amounts. The bill also limits the enrollee/subscriber's cost-sharing responsibilities for out-of-network ambulance services to the in-network amounts. It requires insurers and HMOs to promptly remit payment for covered services directly to the provider, provided the claim is a "clean claim," and to send written notice if the claim is not clean. The bill takes effect on July 1, 2024.

Committee Categories

Budget and Finance, Business and Industry, Health and Social Services

Sponsors (1)

Other Sponsors (1)

Select Committee on Health Innovation (House)

Last Action

Died in Health & Human Services Committee (on 03/08/2024)

bill text


bill summary

Loading...

bill summary

Loading...
Loading...