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HOUSE DOCKET, NO. 268 FILED ON: 1/7/2025
HOUSE . . . . . . . . . . . . . . . No. 1159
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Dennis C. Gallagher
_________________
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 payments for use of ambulance services.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Dennis C. Gallagher8th Plymouth1/7/2025David T. Vieira3rd Barnstable1/27/2025Alyson M. Sullivan-Almeida7th Plymouth3/3/2025 1 of 4
HOUSE DOCKET, NO. 268 FILED ON: 1/7/2025
HOUSE . . . . . . . . . . . . . . . No. 1159
By Representative Gallagher of Bridgewater, a petition (accompanied by bill, House, No. 1159)
of Dennis C. Gallagher, David T. Vieira and Alyson M. Sullivan-Almeida relative to insurance
payments for use of ambulance services. Financial Services.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 992 OF 2023-2024.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act relative to payments 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:
1 Chapter 176D of the General Laws is hereby amended by inserting after section 3B the
2following section:-
3 Section 3C. (a) As used in this section, the following words shall have the following
4meanings, unless the context clearly requires otherwise:-
5 “Ambulance service provider”, a person or entity licensed by the department of public
6health pursuant to section 6 of chapter 111C to establish or maintain an ambulance service.
7 “Emergency ambulance services”, emergency services that an ambulance service
8provider may render under its ambulance service license when a condition or situation in which
9an individual has a need for immediate medical attention or if the individual, bystander or 2 of 4
10emergency medical services provider perceives the potential for the need for immediate medical
11attention.
12 “Insurance policy” and “insurance contract”, any policy, contract, agreement, plan or
13certificate of insurance issued, delivered or renewed within the commonwealth that provides
14coverage for expenses incurred by an insured for transportation services rendered by an
15ambulance service provider.
16 “Insured”, an individual entitled to ambulance services benefits pursuant to an insurance
17policy or insurance contract.
18 “Insurer”, a person as defined in section 1 of chapter 176D; any health maintenance
19organization as defined in section 1 of chapter 176G; a non-profit hospital service corporation
20organized under chapter 176A; any organization as defined in section 1 of chapter 176I that
21participates in a preferred provider arrangement also as defined in said section 1 of said chapter
22176I; any carrier offering a small group health insurance plan under chapter 176J; any company
23as defined in section 1 chapter 175; any employee benefit trust; any self-insurance plan, and any
24company certified under section 34A of chapter 90 and authorized to issue a policy of motor
25vehicle liability insurance under section 113A of chapter 175 that provides insurance for the
26expense of medical coverage.
27 (b) In any instance in which an ambulance service provider provides an emergency
28ambulance service to an insured, but is not an ambulance service provider under contract to the
29insurer maintaining or providing the insured’s insurance policy or insurance contract, the insurer
30maintaining or providing such insurance policy or insurance contract shall pay the ambulance
31service provider directly and promptly for the emergency ambulance service rendered to the 3 of 4
32insured. Such payment shall be made to the ambulance service provider notwithstanding that the
33insureds insurance policy or insurance contract contains a prohibition against the insured
34assigning benefits thereunder so long as the insured executes an assignment of benefits to the
35ambulance service provider and such payment shall be made to the ambulance service provider
36in the event an insured is either incapable or unable as a practical matter to execute an
37assignment of benefits under an insurance policy or insurance contract pursuant to which an
38assignment of benefits is not prohibited, or in connection with an insurance policy or insurance
39contract that contains a prohibition against any such assignment of benefits. An ambulance
40service provider shall not be considered to have been paid for an emergency ambulance service
41rendered to an insured if the insurer makes payment for the emergency ambulance service to the
42insured. An ambulance service provider shall have a right of action against an insurer that fails to
43make a payment to it pursuant to this subsection.
44 (c) With the exception of non-profit corporations licensed to operate critical care
45ambulance services that perform both ground and air transports, payment to an ambulance
46service provider under subsection (b) shall be at a rate equal to the rate established by the
47municipality from where the patient was transported.
48 (d) An ambulance service provider receiving payment for an ambulance service in
49accordance with subsections (b) and (c) shall be deemed to have been paid in full for the
50ambulance service provided to the insured, and shall have no further right or recourse to further
51bill the insured for said ambulance service with the exception of coinsurance, co-payments or
52deductibles for which the insured is responsible under the insureds insurance policy or insurance
53contract. 4 of 4
54 (e) No term or provision of this section 3C shall be construed as limiting or adversely
55affecting an insureds right to receive benefits under any insurance policy or insurance contract
56providing insurance coverage for ambulance services. No term or provision of this section 3C
57shall create an entitlement on behalf of an insured to coverage for ambulance services if the
58insureds insurance policy or insurance contract provides no coverage for ambulance services.