HOUSE DOCKET, NO. 819        FILED ON: 1/17/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 499

 

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

James M. Cantwell

_________________

To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to payments for use of ambulance services.

_______________

PETITION OF:

 

Name:

District/Address:

Date Added:

James M. Cantwell

4th Plymouth

1/17/2017

Jennifer E. Benson

37th Middlesex

1/26/2017

Michael D. Brady

Second Plymouth and Bristol

1/24/2017

Antonio F. D. Cabral

13th Bristol

2/1/2017

Tackey Chan

2nd Norfolk

1/26/2017

Josh S. Cutler

6th Plymouth

1/24/2017

Angelo L. D'Emilia

8th Plymouth

1/19/2017

Geoff Diehl

7th Plymouth

1/26/2017

Diana DiZoglio

14th Essex

1/23/2017

Kenneth J. Donnelly

Fourth Middlesex

2/3/2017

Shawn Dooley

9th Norfolk

1/24/2017

Peter J. Durant

6th Worcester

1/30/2017

James J. Dwyer

30th Middlesex

1/26/2017

Carolyn C. Dykema

8th Middlesex

1/25/2017

Tricia Farley-Bouvier

3rd Berkshire

1/30/2017

Kimberly N. Ferguson

1st Worcester

1/31/2017

William C. Galvin

6th Norfolk

1/25/2017

Carmine L. Gentile

13th Middlesex

1/26/2017

Susan Williams Gifford

2nd Plymouth

1/23/2017

Kenneth I. Gordon

21st Middlesex

1/26/2017

Danielle W. Gregoire

4th Middlesex

1/25/2017

Jonathan Hecht

29th Middlesex

1/27/2017

Paul R. Heroux

2nd Bristol

1/31/2017

Steven S. Howitt

4th Bristol

1/24/2017

Randy Hunt

5th Barnstable

1/29/2017

Louis L. Kafka

8th Norfolk

2/1/2017

John F. Keenan

Norfolk and Plymouth

2/1/2017

Robert M. Koczera

11th Bristol

1/23/2017

Kevin J. Kuros

8th Worcester

2/3/2017

Barbara A. L'Italien

Second Essex and Middlesex

1/25/2017

Paul McMurtry

11th Norfolk

1/20/2017

Mathew Muratore

1st Plymouth

1/24/2017

James M. Murphy

4th Norfolk

2/2/2017

Shaunna L. O'Connell

3rd Bristol

1/23/2017

Keiko M. Orrall

12th Bristol

1/23/2017

Sarah K. Peake

4th Barnstable

1/24/2017

Alice Hanlon Peisch

14th Norfolk

2/3/2017

Angelo J. Puppolo, Jr.

12th Hampden

1/24/2017

John H. Rogers

12th Norfolk

1/24/2017

Richard J. Ross

Norfolk, Bristol and Middlesex

1/23/2017

John W. Scibak

2nd Hampshire

1/24/2017

Todd M. Smola

1st Hampden

1/26/2017

Paul Tucker

7th Essex

1/30/2017

Aaron Vega

5th Hampden

2/1/2017

David T. Vieira

3rd Barnstable

1/23/2017

Chris Walsh

6th Middlesex

1/23/2017

Timothy R. Whelan

1st Barnstable

1/17/2017


HOUSE DOCKET, NO. 819        FILED ON: 1/17/2017

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 499

By Mr. Cantwell of Marshfield, a petition (accompanied by bill, House, No. 499) of James M. Cantwell and others relative to insurance payments for use of ambulance services.  Financial Services.

 

The Commonwealth of Massachusetts

 

_______________

In the One Hundred and Ninetieth General Court
(2017-2018)

_______________

 

An Act relative to payments for use of ambulance services.

 

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 176D of the General Laws is hereby amended by inserting after section 3B the following section:-

Section 3C. (a) As used in this section, the following words shall have the following meanings, unless the context clearly requires otherwise:-

“Ambulance service provider”, a person or entity licensed by the department of public health pursuant to section 6 of chapter 111C to establish or maintain an ambulance service.

“Emergency ambulance services”, emergency services that an ambulance service provider may render under its ambulance service license when a condition or situation in which an individual has a need for immediate medical attention or if the individual, bystander or emergency medical services provider perceives the potential for the need for immediate medical attention.

“Insurance policy” and “insurance contract”, any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides coverage for expenses incurred by an insured for transportation services rendered by an ambulance service provider.

“Insured”, an individual entitled to ambulance services benefits pursuant to an insurance policy or insurance contract.

“Insurer”, a person as defined in section 1 of chapter 176D; any health maintenance organization as defined in section 1 of chapter 176G; a non-profit hospital service corporation organized under chapter 176A; any organization as defined in section 1 of chapter 176I that participates in a preferred provider arrangement also as defined in said section 1 of said chapter 176I; any carrier offering a small group health insurance plan under chapter 176J; any company as defined in section 1 chapter 175; any employee benefit trust; any self-insurance plan, and any company certified under section 34A of chapter 90 and authorized to issue a policy of motor vehicle liability insurance under section 113A of chapter 175 that provides insurance for the expense of medical coverage.

(b) In any instance in which an ambulance service provider provides an emergency ambulance service to an insured, but is not an ambulance service provider under contract to the insurer maintaining or providing the insured’s insurance policy or insurance contract, the insurer maintaining or providing such insurance policy or insurance contract shall pay the ambulance service provider directly and promptly for the emergency ambulance service rendered to the insured. Such payment shall be made to the ambulance service provider notwithstanding that the insureds insurance policy or insurance contract contains a prohibition against the insured assigning benefits thereunder so long as the insured executes an assignment of benefits to the ambulance service provider and such payment shall be made to the ambulance service provider in the event an insured is either incapable or unable as a practical matter to execute an assignment of benefits under an insurance policy or insurance contract pursuant to which an assignment of benefits is not prohibited, or in connection with an insurance policy or insurance contract that contains a prohibition against any such assignment of benefits. An ambulance service provider shall not be considered to have been paid for an emergency ambulance service rendered to an insured if the insurer makes payment for the emergency ambulance service to the insured. An ambulance service provider shall have a right of action against an insurer that fails to make a payment to it pursuant to this subsection.

(c) With the exception of non-profit corporations licensed to operate critical care ambulance services that perform both ground and air transports, payment to an ambulance service provider under subsection (b) shall be at a rate equal to the rate established by the municipality from where the patient was transported.

(d) An ambulance service provider receiving payment for an ambulance service in accordance with subsections (b) and (c) shall be deemed to have been paid in full for the ambulance service provided to the insured, and shall have no further right or recourse to further bill the insured for said ambulance service with the exception of coinsurance, co-payments or deductibles for which the insured is responsible under the insureds insurance policy or insurance contract.

(e) No term or provision of this section 3C shall be construed as limiting or adversely affecting an insureds right to receive benefits under any insurance policy or insurance contract providing insurance coverage for ambulance services. No term or provision of this section 3C shall create an entitlement on behalf of an insured to coverage for ambulance services if the insureds insurance policy or insurance contract provides no coverage for ambulance services.