This bill prohibits an individual or entity from selling, offering for sale, or providing an air ambulance membership agreement to an individual who is enrolled in TennCare. An "air ambulance membership agreement" means an agreement in exchange for consideration to pay for, indemnify, or provide an amount or benefit to a person for the cost of air ambulance services and does not include a health insurance plan or policy.
This bill further requires all air ambulance membership agreement websites, brochures, and marketing material to include the certain disclosures described in the bill about TennCare covering air ambulance transport services and that no out-of-pocket expense is required by an enrollee.
REMEDIES
If an enrollee believes that an individual or entity violated this bill, then this bill authorizes the enrollee to submit a complaint to the consumer protection division of the office of the attorney general. If the division believes, based on a complaint received by the enrollee or another source, that an individual or entity has violated this bill, then the division must fine the individual or entity $5,000 per violation.
For purposes of determining the number of violations committed by the individual or entity, the bill clarifies that each instance of knowingly selling, offering for sale, or providing an air ambulance agreement to an individual who is enrolled in TennCare constitutes a separate violation. Each instance of failing to provide a refund as required under this bill constitutes a separate violation. The division may assess an additional fine for each instance of an individual or entity’s failure to comply with this bill.
If an individual or entity is fined more than $50,000 in a calendar year, then the individual or entity must initiate and complete a corrective action plan as approved by the division. If the division determines that an individual or entity failed to complete a corrective action plan as required under this bill, then the individual or entity loses the individual or entity’s right to sell or otherwise provide memberships for an air ambulance transport service in Tennessee permanently.
APPLICABILITY
This bill applies to conduct occurring on or after July 1, 2023.
ON MARCH 13, 2023, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 504, AS AMENDED.
AMENDMENT #1 limits this bill’s prohibitions to air ambulance membership organizations.
SUBSEQUENT MEDICAID ENROLLMENT
This amendment provides that if an individual who has purchased an air ambulance membership agreement subsequently enrolls in TennCare during the duration of the membership agreement, the enrollee must notify the air ambulance membership organization of such enrollment within 30 days following the effective date of the enrollment. If the enrollee timely notifies the air ambulance membership organization of such enrollment, then the air ambulance membership organization must provide the enrollee a prorated refund of any consideration paid for the period from the effective date of the TennCare Medicaid enrollment through the expiration date of the air ambulance membership agreement. If, however, the enrollee does not timely notify the air ambulance membership organization of such enrollment, then the enrollee is not entitled to a prorated refund, but the air ambulance membership organization is still obligated to disenroll the enrollee within 30 days of receipt of the notice of the enrollee’s enrollment in TennCare Medicaid.
MARKETING AND NOTIFICATION REQUIREMENTS
This amendment requires all air ambulance membership agreement websites, brochures, and marketing material to include, in at least 12-point Times New Roman font or, alternatively, a clear and conspicuous hyperlink, the following disclosures:
(1) The air ambulance membership agreement is a membership plan and is not insurance coverage;
(2) TennCare Medicaid covers air ambulance transport services and requires no out-of-pocket expense by the enrollee for air ambulance transport services; and
(3) Some state laws prohibit Medicaid beneficiaries from being offered air ambulance memberships programs. If an individual submits an air ambulance membership agreement application, the applicant can attest to the fact that the applicant is not currently, nor plans to be enrolled in Medicaid.
This amendment also requires that an air ambulance membership agreement application include in addition to (1)-(3), a disclosure in at least 12-point Times New Roman that informs the applicant that if the applicant is not currently enrolled in Medicaid, but becomes enrolled at any time during the duration of the membership agreement, then the applicant must notify the air ambulance membership organization within 30 days. If the applicant timely notifies the air ambulance membership organization of such enrollment, then the air ambulance membership organization is obligated to provide the applicant a prorated refund of any consideration paid for the air ambulance membership agreement.
REMEDIES
This amendment limits the remedies for a violation of this bill to those the division may seek under the Tennessee Consumer Protection Act of 1977.