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HOUSE DOCKET, NO. 1523        FILED ON: 1/20/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1179

 

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 payment for use of ambulance services.

_______________

PETITION OF:

 

Name:

District/Address:

James M. Cantwell

4th Plymouth

Michael D. Brady

9th Plymouth

Kevin Aguiar

7th Bristol

James Arciero

2nd Middlesex

Bruce J. Ayers

1st Norfolk

Jennifer E. Benson

37th Middlesex

Garrett J. Bradley

3rd Plymouth

William N. Brownsberger

 

Katherine M. Clark

Middlesex and Essex

Angelo L. D'Emilia

8th Plymouth

Geoff Diehl

7th Plymouth

Kimberly N. Ferguson

1st Worcester

John P. Fresolo

16th Worcester

Patricia A. Haddad

5th Bristol

Bradley H. Jones, Jr.

20th Middlesex

John D. Keenan

7th Essex

Thomas P. Kennedy

 

Kevin J. Kuros

8th Worcester

David Paul Linsky

5th Middlesex

Paul McMurtry

11th Norfolk

Richard T. Moore

 

James M. Murphy

4th Norfolk

Kevin J. Murphy

18th Middlesex

Alice Hanlon Peisch

14th Norfolk

Angelo J. Puppolo, Jr.

12th Hampden

Kathi-Anne Reinstein

16th Suffolk

John W. Scibak

2nd Hampshire

James E. Timilty

 

Daniel B. Winslow

9th Norfolk


HOUSE DOCKET, NO. 1523        FILED ON: 1/20/2011

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1179

[Pin Slip]

 

The Commonwealth of Massachusetts

 

_______________

In the Year Two Thousand Eleven

_______________

 

An Act relative to payment 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 31. 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, unless the context clearly requires otherwise, have the following meanings:-

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

                   “Emergency ambulance services”, emergency services that an ambulance service provider is authorized to render under its ambulance service license when a condition or situation in which an individual has a need for immediate medical attention, or where the potential for such need is perceived by the individual, a bystander or an emergency medical services provider.

              “Insurance policy” and “insurance contract”, a contract of insurance, motor vehicle insurance, indemnity, medical or hospital service, dental or optometric, suretyship or annuity issued, proposed for issuance or intended for issuance by any insurer.

              “Insured”, an individual entitled to ambulance services benefits under 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) Notwithstanding any general or special provision of law to the contrary, 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 insured’s 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 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.

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