Legislatively, AB 2593 modifies existing regulations under the Knox-Keene Health Care Service Plan Act and the Health and Safety Code to integrate air ambulance service provisions. This change is significant as it directly affects the financial relationship between patients, air ambulance providers, and insurers. The bill also establishes a framework for reimbursing Medi-Cal fee rates, ensuring that patients who are covered under public assistance programs have their emergency transport needs addressed without excessive out-of-pocket expenses. This is particularly relevant for low-income individuals relying on Medi-Cal for their healthcare needs.
Summary
Assembly Bill 2593, introduced by Assembly Member Grayson, addresses the regulation and reimbursement of air ambulance services in California. The bill mandates that health care service plans and insurance policies issued or renewed on or after January 1, 2019, require enrollees to pay no more than the in-network cost-sharing amount for services received from noncontracting air ambulance providers. This aims to reduce financial burdens on patients who require emergency transport and might otherwise face exorbitant out-of-network charges. Under the bill, noncontracting providers can only advance collections for amounts equivalent to the in-network rates, effectively limiting patient liability.
Sentiment
The sentiment surrounding AB 2593 appears generally positive among supporters who advocate for patient protection against surprise medical bills in emergencies. However, some stakeholders raised concerns about potential impacts on air ambulance services, arguing that restricting reimbursement rates could lead to service provider losses. Overall, the discussions reflected a commitment to improving patient protections while navigating the complexities of healthcare funding and service provision.
Contention
Contention primarily arises from concerns about how the bill will affect air ambulance service providers, particularly regarding the sustainability of their operations under the newly mandated cost-sharing frameworks. Critics question whether capping reimbursements might deter providers from offering essential services in rural or underserved areas, where air ambulance coverage is critical. Additionally, there are worries that if the reimbursement from Medi-Cal and insurance agencies does not sufficiently cover operational costs, some providers might opt to withdraw from participating in Medi-Cal networks entirely.