The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Beth O'Quin.
DIGEST
SB 109 Reengrossed 2023 Regular Session Talbot
Proposed law provides definitions for ambulance provider, clean claim, covered services, enrollee,
healthcare benefit plan, healthcare insurer, and out-of-network.
Proposed law requires the minimum allowable reimbursement rate under any healthcare benefit plan
issued by a healthcare insurer to an out-of-network ambulance provider is one of the following:
(1)At the rates set or approved, whether in contract or ordinance, by a local governmental entity
in the jurisdiction in which the covered healthcare services originate, or as provided by law.
(2)Requires if no rates have been set or approved, the minimum allowable rate of
reimbursement under any health benefit plan issued by any healthcare insurer is 325% of the
current published rate for ambulance services as established by the Centers for Medicare and
Medicaid Services for the same service provided in the same geographic area or the
ambulance provider's billed charges, whichever is less.
Effective August 1, 2023.
(Adds R.S. 22:1880.2)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Insurance to the original bill
1. Provides an air ambulance is not included as an ambulance service provider.
2. Provides definitions for a "clean claim" and "covered services".
3. Makes technical changes.
Senate Floor Amendments to engrossed bill
1. Changes the definition name from "ambulance service provider" to "ambulance
provider".
2. Makes technical changes.