FL S0568

Health insurers and health maintenance organizations offering major medical coverage must reimburse out-of-network ground ambulance service providers at the lowest of three rates: the locally government-approved rate, 325% of the Medicare rate for the same services in the same geographic area, or the provider's billed charges

Patients' cost-sharing responsibilities (copayments, coinsurance, deductibles) for out-of-network ground ambulance services may not exceed what they would pay for in-network ambulance services

Payment by the insured of their applicable copayment, coinsurance, or deductible constitutes full accord and satisfaction, releasing the patient from any additional balance billing claims by the ambulance provider or insurer

Small employer carriers under the Employee Health Care Access Act must comply with the same reimbursement provisions for nonparticipating ambulance service providers

Effective date is January 1, 2025