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Bill > S0568


FL S0568

FL S0568
Coverage for Out-of-network Ground Ambulance Emergency Services


summary

Introduced
11/27/2023
In Committee
12/05/2023
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 s. 627.42398, F.S.; defining the terms “ambulance service provider” and “nonparticipating ambulance service provider”; requiring certain health insurers to reimburse nonparticipating ambulance service providers at a specified rate for providing ground ambulance services; providing that certain payments by the insured constitute an accord and satisfaction of and a release of certain claims; prohibiting certain cost sharing responsibilities paid from exceeding a certain amount; providing that an ambulance service provider and certain claims are subject to certain provisions; amending 627.6699, F.S.; requiring a small employer to comply with certain provisions; amending s. 641.31078, F.S.; defining the terms “ambulance service provider” and “out-of-network ambulance service provider”; requiring certain health maintenance contracts to require a health maintenance organization to reimburse out-of-network ambulance service providers at a specified rate for providing covered services; providing that certain payments by the subscriber constitute an accord and satisfaction of and a release of certain claims; prohibiting certain cost-sharing responsibilities paid from exceeding a certain amount; providing that an ambulance service is considered a provider and certain claims are subject to certain provisions; providing an effective date.

AI Summary

This bill requires certain health insurers and health maintenance organizations (HMOs) in Florida to reimburse non-participating or out-of-network ambulance service providers at specified rates for providing covered ground ambulance services. The bill defines key terms such as "ambulance service provider" and "nonparticipating/out-of-network ambulance service provider." It sets limits on the copayments, coinsurance, and deductibles that can be charged to the insured or subscriber, and provides that payment in full of these cost-sharing responsibilities constitutes an accord and satisfaction of any additional claims. The bill also requires small employer carriers and HMOs to comply with these reimbursement provisions. The provisions in the bill will take effect on January 1, 2025.

Committee Categories

Health and Social Services

Sponsors (1)

Other Sponsors (1)

Banking and Insurance (Senate)

Last Action

Died in Health Policy (on 03/08/2024)

bill text


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