This bill mandates that insurers directly reimburse ambulance service providers for the full amount billed or at rates negotiated between the insurer and the provider. The current language that allows reimbursement to be subject to the terms of the policy has been removed. Instead, the bill stipulates that if no negotiated rates exist, insurers must pay the billed amount, with the insurance department reviewing any disputes regarding the reasonableness of the charges. Additionally, the bill clarifies that it does not apply to policies lacking coverage for ambulance services and allows insurers to negotiate contracts with non-participating ambulance providers.

The bill also includes similar provisions for group and blanket accident or health insurance policies, ensuring that ambulance service providers receive direct reimbursement under the same conditions. The effective date of the act is set for 60 days after its passage. The fiscal impact of the bill is projected to increase claims costs significantly, with estimates suggesting an increase of at least $11.8 million for emergency ground ambulance services. However, the exact financial implications for state and local governments, as well as the insurance market, remain indeterminable at this time.

Statutes affected:
Introduced: 415:6-q, 415:18-v