SB 327 — AN ACT REQUIRING HEALTH INSURANCE COVERAGE FOR MEDICALLY NECESSARY AMBULANCE SERVICES AT AN IN-NETWORK LEVEL AND PROHIBITING BALANCE BILLING FOR SUCH SERVICES.
Last action — REF. TO JOINT COMM. ON Insurance and Real Estate
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✓Introduced
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2In Committee
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3Passed Senate
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4Passed House
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5To Executive
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6Enacted
This bill died with 2019 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Bill Text
What changed in the latest version
101 added · 11 removed101 line(s) added, 11 removed.
General Assembly ProposedCommittee Bill No.
20995470 Referred to Committee on INSURANCE AND REAL ESTATE Introduced by:
(INS) AN ACT REQUIRING HEALTH INSURANCE COVERAGE FOR MEDICALLY NECESSARY AMBULANCE SERVICES AT AN IN- NETWORK LEVEL AND PROHIBITING BALANCE BILLING FOR SUCH SERVICES.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1.
Subsections (a) and (b) of section 20-7f of the general statutes are repealed and the following is substituted in lieu thereof (Effective January 1, 2020):
(a) For purposes of this section:
(1) "Request payment" includes, but is not limited to, submitting a bill for services not actually owed or submitting for such services an invoice or other communication detailing the cost of the services that is not clearly marked with the phrase "This is not a bill".
(2) "Health care provider" means a person licensed to provide health care services under chapters 370 to 373, inclusive, chapters 375 to 383b, inclusive, chapters 384a to [384c] 384d, inclusive, or chapter 400j.
(3) "Enrollee" means a person who has contracted for or who LCO No.
5470 1 of 4 Committee Bill No.327 participates in a health care plan for such enrollee or such enrollee's eligible dependents.
(4) "Coinsurance, copayment, deductible or other out-of-pocket expense" means the portion of a charge for services covered by a health care plan that, under the plan's terms, it is the obligation of the enrollee to pay.
(5) "Health care plan" has the same meaning as provided in subsection (a) of section 38a-477aa.
(6) "Health carrier" has the same meaning as provided in subsection (a) of section 38a-477aa.
(7) "Emergency services" has the same meaning as provided in subsection (a) of section 38a-477aa.
(8) "Medically necessary ambulance services" has the same meaning as that term is used in sections 38a-498 and 38a-525, as amended by this act.
(b) It shall be an unfair trade practice in violation of chapter 735a for any health care provider to request payment from an enrollee, other than a coinsurance, copayment, deductible or other out-of-pocket expense, for (1) health care services or a facility fee, as defined in section 19a-508c, covered under a health care plan, (2) emergency services covered under a health care plan and rendered by an out-of- network health care provider, [or] (3) a surprise bill, as defined in section 38a-477aa, or (4) medically necessary ambulance services in an amount that exceeds the amount allowed under section 38a-498 or 38a- 525, as amended by this act.
Sec.
2.
Subsection (a) of section 38a-498 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2020):
(a) Each individual health insurance policy providing coverage of LCO No.
5470 2 of 4 Committee Bill No.327 the type specified in subdivisions (1), (2), (4), (6), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide coverage for medically necessary ambulance services for persons covered by the policy at an in-network level, including, but not limited to, at an in-network level of cost- sharing.
The hospital policy shall be primary if a person is covered under more than one policy.
The policy shall, as a minimum requirement, cover such services whenever any person covered by the contract is transported when medically necessary by ambulance to a hospital.
Such benefits shall be subject to any policy provision which applies to other services covered by such policies, except that such benefits shall be covered at an in-network level, including, but not limited to, at an in-network level of cost-sharing.
Notwithstanding any other provision of this section, such policies shall not be required to provide benefits in excess of the maximum allowable rate established by the Department of Public Health in accordance with section 19a- 177.
Sec.
3.
Subsection (a) of section 38a-525 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2020):
(a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide coverage for medically necessary ambulance services for persons covered by the policy at an in-network level, including, but not limited to, at an in-network level of cost-sharing.
The hospital policy shall be primary if a person is covered under more than one policy.
The policy shall, as a minimum requirement, cover such services whenever any person covered by the contract is transported when medically necessary by ambulance to a hospital.
Such benefits shall be subject to any policy provision which applies to other services covered by such policies, except that such benefits shall be covered at an in-network level, including, but not limited to, at an LCO No.
5470 3 of 4 Committee Bill No.
327 in-network level of cost-sharing.
Notwithstanding any other provision of this section, such policies shall not be required to provide benefits in excess of the maximum allowable rate established by the Department of Public Health in accordance with section 19a-177.
This act shall take effect as follows and shall amend the following sections:
Section 1 January 1, 2020 20-7f(a) and (b) Sec.
2 January 1, 2020 38a-498(a) Sec.
3 January 1, 2020 38a-525(a) Statement of Purpose:
Show all 50 changed lines (10 more)
To require health insurance coverage for medically necessary ambulance services at an in-network level, including, but not limited to, at an in-network level of cost sharing, and prohibit balance billing for such services.
[Proposed deletions are enclosed in brackets.
Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.] Co-Sponsors:
ANS.B. ACT REQUIRING HEALTH INSURANCE COVERAGE FOR MEDICALLY NECESSARY AMBULANCE SERVICES AT AN IN- NETWORK LEVEL AND PROHIBITING BALANCE BILLING FOR SUCH SERVICES.
Be327 itLCO enactedNo. by the Senate and House of Representatives in General Assembly convened:
That5470 sections4 20-7f, 38a-498 and 38a-525 of the4 general statutes be amended to (1) require health insurance coverage for medically necessary ambulance services at an in-network level, including an in- network level of cost sharing, and (2) prohibit balance billing for medically necessary ambulance services.
Statement of Purpose:
To require health insurance coverage for medically necessary ambulance services at an in-network level, including an in-network level of cost sharing, and prohibit balance billing for such services.
LCO No.
2099 1 of 1
Show all 50 changed rows (10 more)
Action History
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REF. TO JOINT COMM. ON Insurance and Real Estate
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DRAFTED BY COMMITTEE
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Vote to Draft
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PUBLIC HEARING 0214
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Reserved for Subject Matter Public Hearing
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REF. TO JOINT COMM. ON Insurance and Real Estate
Sponsors
- Martin M. Looney · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 186 not signed on
Sponsors (1)
- Martin M. Looney Democratic
Co-sponsors (0)
None.
Not signed on (186)
186 members have not signed on to this bill.
Show all 186 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- Who sponsors SB 327?
- SB 327 is sponsored by Martin M. Looney (Democratic).
- What is the current status of SB 327?
- This bill died with 2019 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track SB 327?
- Track SB 327 free on One Click Politics — get push/email alerts when it moves.
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