Bill Text - SB407 (2024)

(New Title) establishing a ground ambulance cost reporting program and a study by an independent actuarial and accounting expert of the cost of providing ground ambulance services in the state.


Revision: Dec. 12, 2023, 2:46 p.m.

SB 407-FN - AS INTRODUCED

 

 

2024 SESSION

24-3036

05/10

 

SENATE BILL 407-FN

 

AN ACT relative to direct pay for ambulance services.

 

SPONSORS: Sen. Prentiss, Dist 5; Sen. Fenton, Dist 10; Sen. Watters, Dist 4; Sen. Altschiller, Dist 24; Sen. Perkins Kwoka, Dist 21; Sen. Soucy, Dist 18; Sen. Rosenwald, Dist 13; Sen. Whitley, Dist 15; Sen. Gannon, Dist 23; Sen. Innis, Dist 7; Sen. Birdsell, Dist 19; Sen. Carson, Dist 14; Sen. Chandley, Dist 11; Sen. D'Allesandro, Dist 20; Rep. Goley, Hills. 21; Rep. S. Pearson, Rock. 13; Rep. Stringham, Graf. 3; Rep. Wolf, Merr. 7

 

COMMITTEE: Health and Human Services

 

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ANALYSIS

 

This bill requires insurers to directly reimburse ambulance service providers at the usual and customary rate for such services or at the rate negotiated by the insurer and ambulance service provider.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

24-3036

05/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty Four

 

AN ACT relative to direct pay for ambulance services.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

1  Accident and Health Insurance; Individual Policies; Reimbursement for Ambulance Service Providers.  Amend RSA 415:6-q to read as follows:

415:6-q Reimbursement for Ambulance Service Providers.

I. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance that constitutes health coverage under RSA 420-G:2, IX, and that provides benefits for medically necessary ambulance services shall reimburse the ambulance service provider directly [or by a check payable to the insured and the ambulance service provider subject to the terms and conditions of the policy, plan, or contract]. An insurer shall provide reimbursement for ambulance services at rates negotiated between the insurer and the provider of such services. In the absence of agreed upon rates, an insurer shall pay for such services at the usual and customary charge, subject to review by the insurance department in the event of a dispute regarding whether the rate is reasonable. The provisions of this section shall not apply to policies that do not include coverage for ambulance services.

II.  Nothing in this section shall preclude an insurer from negotiating with and subsequently entering into a contract with a non-participating ambulance provider that establishes rates of reimbursement for emergency medical services.

2  Accident and Health Insurance; Group Policies; Reimbursement for Ambulance Service Providers.  Amend RSA 415:18-v to read as follows:

415:18-v Reimbursement for Ambulance Service Providers.

I. Each insurer that issues or renews any policy of group or blanket accident or health insurance that constitutes health coverage under RSA 420-G:2, IX, and that provides benefits for medically necessary ambulance services shall reimburse the ambulance service provider directly [or by a check payable to the insured and the ambulance service provider subject to the terms and conditions of the policy, plan, or contract]. An insurer shall provide reimbursement for ambulance services at rates negotiated between the insurer and the provider of such services. In the absence of agreed upon rates, an insurer shall pay for such services at the usual and customary charge, subject to review by the insurance department in the event of a dispute regarding whether the rate is reasonable. The provisions of this section shall not apply to policies that do not include coverage for ambulance services.

II.  Nothing in this section shall preclude an insurer from negotiating with and subsequently entering into a contract with a non-participating ambulance provider that establishes rates of reimbursement for emergency medical services.

3  Effective Date.  This act shall take effect 60 days after its passage.

 

LBA

24-3036

11/30/23

 

SB 407-FN- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to direct pay for ambulance services.

 

FISCAL IMPACT:      [ X ] State              [ X ] County               [ X ] Local              [    ] None

 

 

Estimated State Impact - Increase / (Decrease)

 

FY 2024

FY 2025

FY 2026

FY 2027

Revenue

$0

Indeterminable

Indeterminable

Indeterminable

Revenue Fund(s)

General Fund

Insurance Premium Tax Revenue

Expenditures

$0

$0

$0

$0

Funding Source(s)

None

 

Appropriations

$0

$0

$0

$0

Funding Source(s)

None

 

Does this bill provide sufficient funding to cover estimated expenditures? [X] N/A

Does this bill authorize new positions to implement this bill? [X] No

 

Estimated Political Subdivision Impact - Increase / (Decrease)

 

FY 2024

FY 2025

FY 2026

FY 2027

County Revenue

$0

$0

$0

$0

County Expenditures

$0

Indeterminable

Indeterminable

Indeterminable

Local Revenue

$0

$0

$0

$0

Local Expenditures

$0

Indeterminable

Indeterminable

Indeterminable

 

METHODOLOGY:

This bill requires insurers to directly reimburse ambulance service providers at the usual and customary rate for such services or at the rate negotiated by the insurer and ambulance service provider.

 

The Insurance Department indicates this bill would amend RSA 415:6-q (individual) and RSA 415:18-v (group) insurance laws by altering language regarding the payment of ambulance service providers.  This bill removes language permitting reimbursement via check issued to the insured and provider, and mandates payment directly to the ambulance service provider.  In addition, the new language directs insurers to reimburse ambulance providers at specific negotiated rates.  In the absence of a negotiated rate, the insurer will be required to pay at the usual charge rate subject to review by the Insurance Department.  Any increase in monthly premiums would depend on the rates negotiated between the insurer and the ambulance provider.  If negotiated rates are higher than what the insurer is currently paying, it may result in an increase in premiums resulting in additional premium tax revenue.  To the extent premiums increase county and local expenditures for health insurance may also increase.  The Department anticipates existing staff could absorb any work related to reviewing rate disputes between ambulance providers and insurers.   Overall, the fiscal impact is indeterminable.

 

AGENCIES CONTACTED:

Department of Insurance