Introduced Version
House Bill 2926 History
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Key: Green = existing Code. Red = new code to be enacted
H. B. 2926
(By Delegates Longstreth, M. Poling, Staggers, Caputo,
Manchin, Manypenny and Fleischauer)
[Introduced March 13, 2013; referred to the
Committee on Health and Human Resources then Finance.]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new section designated §33-15-22; to further
amend said code by adding thereto a new section, designated
§33-16-18; to further amend said code by adding thereto a new
section, designated §33-24-15; to further amend said code by
adding thereto a new section, designated §33-25-15; and to
further amend said code by adding thereto a new section,
designated §33-25A-29, all relating to requiring health
insurers to reimburse ambulance service providers directly for
ambulance services covered under a person's health insurance
policy, plan or contract.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new section, designated §33-15-22; that said
code be further amended by adding thereto a new section, designated
§33-16-18; that said code be further amended by adding thereto a new section, designated §33-24-15; that said code be further
amended by adding thereto a new section, designated §33-25-15; and
that said code be further amended by adding thereto a new section,
designated §33-25A-29, all to read as follows:
ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
§33-15-22. Direct reimbursement for ambulance service providers.
_____(a) When an ambulance service provider provides emergency
medical ambulance services to a person who is insured by a health
insurance policy, health care services plan, or contract that
provides benefits for emergency medical ambulance services under
this article, the health insurer shall reimburse the ambulance
service provider directly for the covered services provided under
the insured's policy, plan or contract.
_____(b) Nothing in this section may be construed to interfere with
coordination of benefits or to require a health insurer to provide
coverage for services not otherwise covered under the insured's
policy, plan or contract.
_____(c) Nothing in this section precludes a health insurer from
negotiating with and subsequently entering into a contract with a
nonparticipating ambulance service provider to establish rates of
reimbursement for emergency medical ambulance services.
_____
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-18. Direct reimbursement for ambulance service providers.
_____(a) When an ambulance service provider provides emergency
medical ambulance services to a person who is insured by a health
insurance policy, health care services plan, or contract that
provides benefits for emergency medical ambulance services under
this article, the health insurer shall reimburse the ambulance
service provider directly for the covered services provided under
the insured's policy, plan or contract.
_____(b) Nothing in this section may be construed to interfere with
coordination of benefits or to require a health insurer to provide
coverage for services not otherwise covered under the insured's
policy, plan or contract.
_____(c) Nothing in this section precludes a health insurer from
negotiating with and subsequently entering into a contract with a
nonparticipating ambulance service provider to establish rates of
reimbursement for emergency medical ambulance services.
ARTICLE 24. HOSPITAL SERVICE CORPORATIONS, MEDICAL SERVICE
CORPORATIONS, DENTAL SERVICE CORPORATIONS AND HEALTH SERVICE
CORPORATIONS.
§33-24-15. Direct reimbursement for ambulance service providers.
__(a) When an ambulance service provider provides emergency
medical ambulance services to a person who is insured by a health
insurance policy, health care services plan, or contract that
provides benefits for emergency medical ambulance services under this article, the health insurer shall reimburse the ambulance
service provider directly for the covered services provided under
the insured's policy, plan or contract._
__(b) Nothing in this section may be construed to interfere with
coordination of benefits or to require a health insurer to provide
coverage for services not otherwise covered under the insured's
policy, plan or contract.
__(c) Nothing in this section precludes a health insurer from
negotiating with and subsequently entering into a contract with a
nonparticipating ambulance service provider to establish rates of
reimbursement for emergency medical ambulance services.
ARTICLE 25. HEALTH CARE CORPORATIONS.
§33-25-15. Direct reimbursement for ambulance service providers.
_____(a) When an ambulance service provider provides emergency
medical ambulance services to a person who is insured by a health
insurance policy, health care services plan, or contract that
provides benefits for emergency medical ambulance services under
this article, the health insurer shall reimburse the ambulance
service provider directly for the covered services provided under
the insured's policy, plan or contract._
_____(b) Nothing in this section may be construed to interfere with
coordination of benefits or to require a health insurer to provide
coverage for services not otherwise covered under the insured's
policy, plan or contract.
_____(c) Nothing in this section precludes a health insurer from
negotiating with and subsequently entering into a contract with a
nonparticipating ambulance service provider to establish rates of
reimbursement for emergency medical ambulance services.
ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION ACT.
§33-25A-29. Direct reimbursement for ambulance service providers.
_____(a) When an ambulance service provider provides emergency
medical ambulance services to a person who is insured by a health
insurance policy, health care services plan, or contract that
provides benefits for emergency medical ambulance services under
this article, the health insurer shall reimburse the ambulance
service provider directly for the covered services provided under
the insured's policy, plan or contract.
_____(b) Nothing in this section may be construed to interfere with
coordination of benefits or to require a health insurer to provide
coverage for services not otherwise covered under the insured's
policy, plan or contract.
_____(c) Nothing in this section precludes a health insurer from
negotiating with and subsequently entering into a contract with a
nonparticipating ambulance service provider to establish rates of
reimbursement for emergency medical ambulance services.
NOTE: The purpose of this bill is to
require health insurers to reimburse ambulance service providers directly for ambulance
services covered under a person's health insurance policy, plan or
contract.
§33-15-22, §33-16-18, §33-24-15, §33-25-15 and §33-25A-29 are
new; therefore, they have been completely underscored.