Florida Senate - 2020                                     SB 736
       
       
        
       By Senator Diaz
       
       
       
       
       
       36-00958A-20                                           2020736__
    1                        A bill to be entitled                      
    2         An act relating to coverage for air ambulance
    3         services; creating s. 627.42397, F.S.; defining terms;
    4         requiring health insurers and health maintenance
    5         organizations to provide reasonable reimbursement to
    6         air ambulance services for certain covered services;
    7         providing that such reimbursement may be reduced only
    8         by certain amounts; providing that reasonable
    9         reimbursement must serve as full and final payment to
   10         the air ambulance service; providing applicability;
   11         providing an effective date.
   12          
   13  Be It Enacted by the Legislature of the State of Florida:
   14  
   15         Section 1. Section 627.42397, Florida Statutes, is created
   16  to read:
   17         627.42397 Coverage for air ambulance services.—
   18         (1) As used in this section, the term:
   19         (a) “Air ambulance service” has the same meaning as
   20  provided in s. 401.23.
   21         (b) “Health insurer” means an authorized insurer offering
   22  health insurance as defined in s. 624.603.
   23         (c) “Health maintenance organization” has the same meaning
   24  as provided in s. 641.19(12).
   25         (d) “Reasonable reimbursement” means reimbursement that
   26  considers the actual cost of services rendered, the operation of
   27  air ambulances in areas of critical need, the operation of an
   28  air ambulance service by a county which operates entirely within
   29  a designated area of critical state concern as determined by the
   30  Department of Economic Opportunity, and usual and customary
   31  reimbursement.
   32         (2) A health insurance policy or health maintenance
   33  contract must require a health insurer or health maintenance
   34  organization to provide reasonable reimbursement to air
   35  ambulance services for covered nonemergency and emergency
   36  services provided to an insured or subscriber in accordance with
   37  the coverage terms of the policy or contract. Such reasonable
   38  reimbursement may be reduced only by applicable copayments,
   39  coinsurance, and deductibles, unless the insured or subscriber
   40  has expressly or in fact contracted for a different amount. The
   41  reasonable reimbursement must serve as full and final payment to
   42  the air ambulance service.
   43         (3) This section does not apply to a policy or contract
   44  providing any health care benefit pursuant to Title XVIII
   45  (Medicare), Title XIX (Medicaid), or Title XXI (the Children’s
   46  Health Insurance Program) of the Social Security Act or any
   47  regulations promulgated thereunder.
   48         Section 2. This act shall take effect upon becoming a law.