| 3 | 2 | | *ANS340* 03/19/2025 4:34:55 PM ANS340 |
|---|
| 4 | 3 | | State of Arkansas 1 |
|---|
| 5 | 4 | | 95th General Assembly A Bill 2 |
|---|
| 6 | 5 | | Regular Session, 2025 HOUSE BILL 1863 3 |
|---|
| 7 | 6 | | 4 |
|---|
| 8 | 7 | | By: Representatives L. Johnson, Perry 5 |
|---|
| 9 | 8 | | By: Senator Irvin 6 |
|---|
| 10 | 9 | | 7 |
|---|
| 11 | 10 | | For An Act To Be Entitled 8 |
|---|
| 12 | 11 | | AN ACT TO AMEND THE TRANSPORTATION BENEFIT MANAGER 9 |
|---|
| 13 | 12 | | ACT; TO DECLARE AN EMERGENCY; AND FOR OTHER PURPOSES. 10 |
|---|
| 14 | 13 | | 11 |
|---|
| 15 | 14 | | 12 |
|---|
| 16 | 15 | | Subtitle 13 |
|---|
| 17 | 16 | | TO AMEND THE TRANSPORTATION BENEFIT 14 |
|---|
| 18 | 17 | | MANAGER ACT; AND TO DECLARE AN 15 |
|---|
| 19 | 18 | | EMERGENCY. 16 |
|---|
| 20 | 19 | | 17 |
|---|
| 21 | 20 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 18 |
|---|
| 22 | 21 | | 19 |
|---|
| 23 | 22 | | SECTION 1. Arkansas Code § 23-99-1705 is amended to read as follows: 20 |
|---|
| 24 | 23 | | 23-99-1705. Claims. 21 |
|---|
| 25 | 24 | | (a) A contracting entity shall pay a claim for ambulance services for 22 |
|---|
| 26 | 25 | | which prior authorization was received regardless of the terminology used by 23 |
|---|
| 27 | 26 | | the transportation benefit manager or health benefit plan within thirty (30) 24 |
|---|
| 28 | 27 | | days of receipt of the claim from an ambulance provider, unless: 25 |
|---|
| 29 | 28 | | (1) Authorized ambulance services were never performed; or 26 |
|---|
| 30 | 29 | | (2) There is specific information available for review by the 27 |
|---|
| 31 | 30 | | appropriate state or federal agency that the subscriber or ambulance provider 28 |
|---|
| 32 | 31 | | has engaged in material misrepresentation, fraud, or abuse regarding the 29 |
|---|
| 33 | 32 | | claim for the authorized ambulance services. 30 |
|---|
| 34 | 33 | | (b)(1) A healthcare insurer or transportation benefit manager shall 31 |
|---|
| 35 | 34 | | pay two hundred fifty percent (250%) of the Medicare Ambulance Fee Schedule, 32 |
|---|
| 36 | 35 | | Rural Rate for a claim for ambulance services to an ambulance provider. 33 |
|---|
| 37 | 36 | | (2) An ambulance provider shall accept the payment under 34 |
|---|
| 38 | 37 | | subdivision (b)(1) of this section as payment in full for services provided 35 |
|---|
| 39 | 38 | | to the subscriber. 36 HB1863 |
|---|
| 40 | 39 | | |
|---|
| 41 | 40 | | 2 03/19/2025 4:34:55 PM ANS340 |
|---|
| 42 | 41 | | (3) An ambulance provider shall not balance bill or otherwise 1 |
|---|
| 43 | 42 | | demand a payment from the subscriber other than a deductible, copayment, or 2 |
|---|
| 44 | 43 | | coinsurance required under the subscriber's health benefit plan. 3 |
|---|
| 45 | 44 | | (c) Ambulance services authorized or guaranteed for payment under this 4 |
|---|
| 46 | 45 | | section for which the prior authorization is not rescinded or reversed under 5 |
|---|
| 47 | 46 | | subsection (a) of this section are not subject to audit recoupment. 6 |
|---|
| 48 | 47 | | (d)(c) A claim submitted by an ambulance provider shall include any 7 |
|---|
| 49 | 48 | | information as required by the Insurance Commissioner. 8 |
|---|
| 50 | 49 | | 9 |
|---|
| 51 | 50 | | SECTION 2. Arkansas Code § 23 -99-1706, concerning enforcement and 10 |
|---|
| 52 | 51 | | rules of the Transportation Benefit Manager Act, is amended to add an 11 |
|---|
| 53 | 52 | | additional subsection to read as follows: 12 |
|---|
| 54 | 53 | | (d)(1) On and after July 1, 2025, the Arkansas Ambulance Association 13 |
|---|
| 55 | 54 | | shall collect the rates that are approved or contracted for between an 14 |
|---|
| 56 | 55 | | ambulance provider and a local government entity as provided for under § 14 -15 |
|---|
| 57 | 56 | | 266-105. 16 |
|---|
| 58 | 57 | | (2) The information required under subdivision (d)(1) of this 17 |
|---|
| 59 | 58 | | section shall be submitted annually to the commissioner. 18 |
|---|
| 60 | 59 | | 19 |
|---|
| 61 | 60 | | SECTION 3. EMERGENCY CLAUSE. It is found and determined by the 20 |
|---|
| 62 | 61 | | General Assembly of the State of Arkansas that it is necessary to resolve a 21 |
|---|
| 63 | 62 | | conflict regarding in -network and out-of-network reimbursement rates for 22 |
|---|
| 64 | 63 | | ambulance services; that the conflict is causing confusion between ambulance 23 |
|---|
| 65 | 64 | | providers, insurers, and the State Insurance Department; and that this act is 24 |
|---|
| 66 | 65 | | immediately necessary to alleviate confusion concerning reimbursement rates 25 |
|---|
| 67 | 66 | | for ambulance services. Therefore, an emergency is declared to exist, and 26 |
|---|
| 68 | 67 | | this act being immediately necessary for the preservation of the public 27 |
|---|
| 69 | 68 | | peace, health, and safety shall become effective on: 28 |
|---|
| 70 | 69 | | (1) The date of its approval by the Governor; 29 |
|---|
| 71 | 70 | | (2) If the bill is neither approved nor vetoed by the Governor, 30 |
|---|
| 72 | 71 | | the expiration of the period of time during which the Governor may veto the 31 |
|---|
| 73 | 72 | | bill; or 32 |
|---|
| 74 | 73 | | (3) If the bill is vetoed by the Governor and the veto is 33 |
|---|
| 75 | 74 | | overridden, the date the last house overrides the veto. 34 |
|---|
| 76 | 75 | | 35 |
|---|