Revision: March 6, 2025, 8:06 a.m.
Senate Health and Human Services
March 5, 2025
2025-0775s
05/06
Amendment to SB 245-FN
Amend RSA 420-J:8-i, I as inserted by section 1 of the bill by replacing it with the following:
I. With respect to a claim for covered services rendered by a non-participating ground ambulance service provider, the health carrier shall directly reimburse the non-participating ground emergency ambulance service provider the rates set or approved, whether in contract, in ordinance, or otherwise, by a local governmental entity in the jurisdiction in which the non-participating ground emergency services originated. If the local government entity having jurisdiction where the ground emergency ambulance service originated does not have set or approved rates, the health carrier shall directly reimburse the non-participating ground emergency ambulance service provider a minimum of 325 percent of the current urban, rural or super rural Medicare rates based on the geographic area where the ground emergency ambulance service originated.
(a) The payment shall be considered payment in full for the ambulance service provided, except for any copayment, coinsurance, deductible, and other cost sharing amounts that the carrier requires the covered individual to pay; and
(b) The non-participating ambulance service provider is prohibited from billing the covered individual for any additional amount for the ambulance service provided except for any copayment, coinsurance, deductible, and other cost sharing amounts that the carrier requires the covered individual to pay.
Amend RSA 420-J:8-i, V and VI as inserted by section 1 of the bill by replacing it with the following:
V. A health carrier shall reimburse a non-participating ground emergency ambulance provider in accordance with RSA 420-J:8-a, the prompt payment requirements.
VI. A health carrier shall clearly indicate on all payment explanations of benefits whether the claim relates to an insurance plan subject to the jurisdiction of the commissioner.