CT SB00324

Individual and group health insurance policies must cover medically necessary ambulance services at in-network levels with in-network cost-sharing, including transportation to hospitals and from hospitals to a covered person's residence, effective January 1, 2021.

Insurance payments for emergency ambulance services must be paid directly to the ambulance provider if the provider indicates the bill is subject to assignment, either by stamping paper bills or including the indication in electronic submissions.

Ambulance providers must disclose the potential cost to patients and obtain written consent before providing transportation services if the provider reasonably believes the services are nonemergency rather than emergency.

Benefits are limited to the maximum allowable rate established by the Department of Public Health under section 19a-177, and hospital policies are primary if a person is covered under multiple policies.

The direct payment requirements do not apply to transactions where an ambulance provider and insurance entity have a contract specifically providing for direct payment.