Florida Senate - 2020 CS for CS for CS for SB 736
By the Committees on Rules; Health Policy; and Banking and
Insurance; and Senator Diaz
595-04467-20 2020736c3
1 A bill to be entitled
2 An act relating to coverage for air ambulance
3 services; creating ss. 627.42397 and 641.514, F.S.;
4 defining terms; requiring health insurers and health
5 maintenance organizations, respectively, to provide
6 reasonable reimbursement to air ambulance services for
7 certain covered services; providing that such
8 reimbursement may be reduced only by certain amounts;
9 providing that full payment of an applicable
10 copayment, coinsurance, or deductible constitutes an
11 accord, satisfaction, and release of certain claims;
12 providing that provisions of this act are not
13 severable; providing construction; providing an
14 effective date.
15
16 Be It Enacted by the Legislature of the State of Florida:
17
18 Section 1. Section 627.42397, Florida Statutes, is created
19 to read:
20 627.42397 Coverage for air ambulance services.—
21 (1) As used in this section, the term:
22 (a) “Air ambulance service” has the same meaning as
23 provided in s. 401.23.
24 (b) “Health insurer” means an authorized insurer offering
25 health insurance as defined in s. 624.603.
26 (c) “Reasonable reimbursement” means reimbursement that
27 considers the direct cost to provide air ambulance
28 transportation service to an insured, the operation of an air
29 ambulance service by a county which operates entirely within a
30 designated area of critical state concern as determined by the
31 Department of Economic Opportunity, and in-network reimbursement
32 established by the insurer for the specific policy. The term
33 does not include the amount of billed charges for the cost of
34 services rendered.
35 (2) A health insurance policy must require a health insurer
36 to provide reasonable reimbursement to an air ambulance service
37 for covered nonemergency and emergency services provided to an
38 insured in accordance with the coverage terms of the policy.
39 Such reasonable reimbursement may be reduced only by applicable
40 copayments, coinsurance, and deductibles. Payment in full by the
41 insured of his or her applicable copayment, coinsurance, or
42 deductible constitutes an accord and satisfaction of, and
43 constitutes a release of, any claim for additional moneys owed
44 by the insured to the health insurer or to any person or entity
45 in connection with the air ambulance service.
46 Section 2. Section 641.514, Florida Statutes, is created to
47 read:
48 641.514 Coverage for air ambulance services.—
49 (1) As used in this section, the term:
50 (a) “Air ambulance service” has the same meaning as
51 provided in s. 401.23.
52 (b) “Reasonable reimbursement” means reimbursement that
53 considers the direct cost to provide air ambulance
54 transportation service to a subscriber, the operation of an air
55 ambulance service by a county which operates entirely within a
56 designated area of critical state concern as determined by the
57 Department of Economic Opportunity, and in-network reimbursement
58 established by the health maintenance organization for the
59 specific health maintenance contract. The term does not include
60 the amount of billed charges for the cost of services rendered.
61 (2) A health maintenance contract must require a health
62 maintenance organization to provide reasonable reimbursement to
63 an air ambulance service for covered nonemergency and emergency
64 services provided to a subscriber in accordance with the
65 coverage terms of the policy. Such reasonable reimbursement may
66 be reduced only by applicable copayments, coinsurance, and
67 deductibles. Payment in full by the subscriber of his or her
68 applicable copayment, coinsurance, or deductible constitutes an
69 accord and satisfaction of, and constitutes a release of, any
70 claim for additional moneys owed by the subscriber to the health
71 maintenance organization or to any person or entity in
72 connection with the air ambulance service.
73 Section 3. If any provision of s. 627.42397 or s. 641.514,
74 Florida Statutes, as created by this act is determined to be
75 invalid or inoperative for any reason, the remaining provisions
76 thereof shall be deemed to be void and of no effect. To this
77 end, the Legislature declares that it would not have enacted any
78 of the provisions of s. 627.42397 or s. 641.514, Florida
79 Statutes, individually, and expressly finds them not to be
80 severable.
81 Section 4. Nothing in this act shall be construed to give
82 retroactive application or to impair any contract existing
83 before or on the effective date of this act, or to otherwise
84 restrict the ability of an air ambulance service, as defined in
85 s. 401.23, Florida Statutes, to contract to provide nonemergency
86 and emergency services.
87 Section 5. This act shall take effect upon becoming a law.