FL S0516

Creates section 627.64194, F.S. to establish requirements for health insurance coverage of emergency services and emergency medical transportation.

Prohibits insurers from requiring prior authorization for emergency services coverage.

Requires coverage to be provided regardless of whether services are furnished by participating or nonparticipating providers, with identical coinsurance, copayment, and benefit limitations applied to both.

Establishes reimbursement requirements for nonparticipating providers using the greater of: negotiated rates with participating providers, the insurer's standard methodology (e.g., usual and customary amounts), or Medicare payment amounts, minus applicable patient cost-sharing.

Prohibits nonparticipating providers from collecting or attempting to collect amounts in excess of specified reimbursement limits; effective October 1, 2015.