Revision: April 3, 2024, 10:22 a.m.
Senate Finance
April 3, 2024
2024-1422s
05/08
Amendment to SB 407-FN
Amend the bill by replacing all after the enacting clause with the following:
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 rates set by the local government or contracted entity subject to a public process prior to adoption or readoption, or at the rate of 325 percent of the published rate for ambulance services established under the Medicare law for the same ambulance service provided in the same geographic area, or according to the participating ambulance provider's billed charges, whichever is the lesser amount. All current rates set by local government and the entities shall remain in place unless a change is proposed. This section shall apply to unscheduled emergency calls and emergency interfacility transfers. 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.
III. In the event of a dispute between a health care provider and an insurance carrier relative to this process, RSA 420-J:8-e shall apply.
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 rates set by the local government or contracted entity subject to a public process prior to adoption or readoption, or at the rate of 325 percent of the published rate for ambulance services established under the Medicare law for the same ambulance service provided in the same geographic area, or according to the participating ambulance provider's billed charges, whichever is the lesser amount. All current rates set by local government and the entities shall remain in place unless a change is proposed. This section shall apply to unscheduled emergency calls and emergency interfacility transfers. 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.
III. In the event of a dispute between a health care provider and an insurance carrier relative to this process, RSA 420-J:8-e shall apply.
3 Effective Date. This act shall take effect 60 days after its passage.