Bill Numbers

Key Provisions for talking points

  • Would mandate certain health plans detailed in this legislation to provide prompt payment
  • Would apply to health plans sold with very high deductibles. $3,000 per person or $6,000 annually
  • Applies to all emergency ambulance transport and emergency department care
  • Mandates the health plan pay the providers directly for their charges, and mandates the health plan collect from the high-deductible enrollee
Why we need an alternative mechanism for prompt payment

Protecting and sustaining the emergency care safety net for emergency ambulance services and Emergency Departments 

  • Uncompensated care is at record levels
  • Medicaid and Medicare pay below cost to offer the care
  • Currently, the provider accepts all financial risk for providing service. This bill would pull the health plans into that conversation, as they are the entities receiving payment from the patient.
  • Under EMTALA, emergency medicine physicians and ambulance services are required to care for every patient that enters the ED or the ambulance. However, there is no guarantee that they will receive payment for the care provided.