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FL H0639
Bill
Status
Failed
3/8/2024
Primary Sponsor
Select Committee on Health Innovation
Click for details
AI Summary
- Health insurers and health maintenance organizations must reimburse out-of-network ground ambulance providers for emergency services at the lesser (for insurers) or greater (for HMOs) of three rates: the local government-approved rate, 350% of the Medicare rate (or billed charges, whichever is less), or the insurer's in-network contracted rate
- Out-of-network ambulance providers are prohibited from balance billing patients beyond the insurer's payment; the reimbursement constitutes payment in full except for the enrollee's standard cost-sharing obligations
- Patient cost-sharing (copayments, coinsurance, deductibles) for out-of-network ground ambulance services may not exceed what the patient would owe for in-network ambulance services
- Insurers and HMOs must pay clean claims directly to the ambulance provider within 30 days and must treat ambulance transport as medically necessary when requested by a first responder or health care practitioner
- Non-clean claims require a written response within 30 days specifying the reason for denial or identifying what additional information is needed; the act applies only to ground ambulance services and excludes air ambulance, with an effective date of July 1, 2024
Legislative Description
Coverage of Out-of-network Ground Ambulance Emergency Services
Last Action
Died in Health & Human Services Committee
3/8/2024
Committee Referrals
Health And Human Services2/14/2024
Appropriations2/7/2024
Insurance And Banking Subcommittee2/2/2024
Select Committee on Health Innovation11/30/2023
Full Bill Text
No bill text available