Bill Text: CA AB2593 | 2017-2018 | Regular Session | Amended
Bill Title: Air ambulance services.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Vetoed) 2018-09-27 - Vetoed by Governor. [AB2593 Detail]
Download: California-2017-AB2593-Amended.html
Amended
IN
Senate
July 03, 2018 |
Amended
IN
Senate
June 18, 2018 |
Amended
IN
Assembly
May 25, 2018 |
Assembly Bill | No. 2593 |
Introduced by Assembly Member Grayson (Principal coauthor: Assembly Member Wood) (Coauthor: Senator Dodd) |
February 15, 2018 |
LEGISLATIVE COUNSEL'S DIGEST
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1371.6 is added to the Health and Safety Code, to read:(a)A subscriber or enrollee receiving emergency transportation by an air ambulance services provider covered consistent with paragraph (6) of subdivision (b) of Section 1345 shall not be held liable for the cost of that service, except for applicable cost-sharing amounts, including, but not limited to, a copayment, coinsurance, or a deductible.
(b)(1)A health care service plan shall reimburse providers for services subject to this section in accordance with this chapter, including Section 1371 or 1371.35, as applicable, and the health care service plan shall provide an explanation of benefits or similar claim processing information to the enrollee
and provider.
(2)Notwithstanding any other law, reimbursement shall be based on either the reasonable and customary value for the service as described in subparagraph (B) of paragraph (3) of subdivision (a) of Section 1300.71 of Title 28 of the California Code of Regulations or an amount otherwise negotiated between the health care service plan and the provider.
1371.6.
(a) (1) Notwithstanding Section 1367.11, a health care service plan contract issued, amended, or renewed on or after January 1, 2019, shall provide that if an enrollee receives covered services from a noncontracting air ambulance provider, the enrollee shall pay no more than the same cost sharing that the enrollee would pay for the same covered services received from a contracting air ambulance provider. This amount shall be referred to as the “in-network cost-sharing amount.”(3)
(c)The provisions of this section are severable. If any provision of this section or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.
SEC. 2.
Section 10126.65 is added to the Insurance Code, to read:(a)An insured receiving emergency transportation by an air ambulance services provider covered consistent with paragraph (6) of subdivision (b) of Section 1345 shall not be held liable for the cost of that service, except for applicable cost-sharing amounts, including, but not limited to, a copayment, coinsurance, or a deductible.
(b)Notwithstanding any other law, a health insurer shall provide an explanation of benefits to the insured or an explanation of benefits or remittance advice to the provider concerning air ambulance services.
(c)(1)A health
insurer shall provide reimbursement, in accordance with this chapter, to a provider for a claim submitted for air ambulance services.
(2)Reimbursement to a provider shall be based on either the reasonable and customary value for the service as described in subparagraph (B) of paragraph (3) of subdivision (a) of Section 1300.71 of Title 28 of the California Code of Regulations or an amount otherwise negotiated between the health insurer and the provider.
10126.65.
(a) (1) Notwithstanding Section 10352, a health insurance policy issued, amended, or renewed on or after January 1, 2019, shall provide that if an insured or subscriber receives covered services from a noncontracting air ambulance provider, the insured or subscriber shall pay no more than the same cost sharing that the insured or subscriber would pay for the same covered services received from a contracting air ambulance provider. This amount shall be referred to as the “in-network cost-sharing amount.”(3)
(d)The provisions of this section are severable. If any provision of this section or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.
SEC. 3.
Section14124.14.14124.15.
(a) The department shall set and maintain the Medi-Cal fee rate for air ambulance services provided either by fixed or rotary wing aircraft that is equal to a percentage, as specified in subdivision (b), of the rural Medicare rates for those services.(c)