Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1159 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	HOUSE DOCKET, NO. 268 FILED ON: 1/7/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1159
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Dennis C. Gallagher
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to payments for use of ambulance services.
13	13	_______________
14	14	PETITION OF:
15	15	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
16	16	HOUSE DOCKET, NO. 268 FILED ON: 1/7/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 1159
18	18	By Representative Gallagher of Bridgewater, a petition (accompanied by bill, House, No. 1159)
19	19	of Dennis C. Gallagher, David T. Vieira and Alyson M. Sullivan-Almeida relative to insurance
20	20	payments for use of ambulance services. Financial Services.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE HOUSE, NO. 992 OF 2023-2024.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Fourth General Court
26	26	(2025-2026)
27	27	_______________
28	28	An Act relative to payments for use of ambulance services.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 Chapter 176D of the General Laws is hereby amended by inserting after section 3B the
32	32	2following section:-
33	33	3 Section 3C. (a) As used in this section, the following words shall have the following
34	34	4meanings, unless the context clearly requires otherwise:-
35	35	5 “Ambulance service provider”, a person or entity licensed by the department of public
36	36	6health pursuant to section 6 of chapter 111C to establish or maintain an ambulance service.
37	37	7 “Emergency ambulance services”, emergency services that an ambulance service
38	38	8provider may render under its ambulance service license when a condition or situation in which
39	39	9an individual has a need for immediate medical attention or if the individual, bystander or 2 of 4
40	40	10emergency medical services provider perceives the potential for the need for immediate medical
41	41	11attention.
42	42	12 “Insurance policy” and “insurance contract”, any policy, contract, agreement, plan or
43	43	13certificate of insurance issued, delivered or renewed within the commonwealth that provides
44	44	14coverage for expenses incurred by an insured for transportation services rendered by an
45	45	15ambulance service provider.
46	46	16 “Insured”, an individual entitled to ambulance services benefits pursuant to an insurance
47	47	17policy or insurance contract.
48	48	18 “Insurer”, a person as defined in section 1 of chapter 176D; any health maintenance
49	49	19organization as defined in section 1 of chapter 176G; a non-profit hospital service corporation
50	50	20organized under chapter 176A; any organization as defined in section 1 of chapter 176I that
51	51	21participates in a preferred provider arrangement also as defined in said section 1 of said chapter
52	52	22176I; any carrier offering a small group health insurance plan under chapter 176J; any company
53	53	23as defined in section 1 chapter 175; any employee benefit trust; any self-insurance plan, and any
54	54	24company certified under section 34A of chapter 90 and authorized to issue a policy of motor
55	55	25vehicle liability insurance under section 113A of chapter 175 that provides insurance for the
56	56	26expense of medical coverage.
57	57	27 (b) In any instance in which an ambulance service provider provides an emergency
58	58	28ambulance service to an insured, but is not an ambulance service provider under contract to the
59	59	29insurer maintaining or providing the insured’s insurance policy or insurance contract, the insurer
60	60	30maintaining or providing such insurance policy or insurance contract shall pay the ambulance
61	61	31service provider directly and promptly for the emergency ambulance service rendered to the 3 of 4
62	62	32insured. Such payment shall be made to the ambulance service provider notwithstanding that the
63	63	33insureds insurance policy or insurance contract contains a prohibition against the insured
64	64	34assigning benefits thereunder so long as the insured executes an assignment of benefits to the
65	65	35ambulance service provider and such payment shall be made to the ambulance service provider
66	66	36in the event an insured is either incapable or unable as a practical matter to execute an
67	67	37assignment of benefits under an insurance policy or insurance contract pursuant to which an
68	68	38assignment of benefits is not prohibited, or in connection with an insurance policy or insurance
69	69	39contract that contains a prohibition against any such assignment of benefits. An ambulance
70	70	40service provider shall not be considered to have been paid for an emergency ambulance service
71	71	41rendered to an insured if the insurer makes payment for the emergency ambulance service to the
72	72	42insured. An ambulance service provider shall have a right of action against an insurer that fails to
73	73	43make a payment to it pursuant to this subsection.
74	74	44 (c) With the exception of non-profit corporations licensed to operate critical care
75	75	45ambulance services that perform both ground and air transports, payment to an ambulance
76	76	46service provider under subsection (b) shall be at a rate equal to the rate established by the
77	77	47municipality from where the patient was transported.
78	78	48 (d) An ambulance service provider receiving payment for an ambulance service in
79	79	49accordance with subsections (b) and (c) shall be deemed to have been paid in full for the
80	80	50ambulance service provided to the insured, and shall have no further right or recourse to further
81	81	51bill the insured for said ambulance service with the exception of coinsurance, co-payments or
82	82	52deductibles for which the insured is responsible under the insureds insurance policy or insurance
83	83	53contract. 4 of 4
84	84	54 (e) No term or provision of this section 3C shall be construed as limiting or adversely
85	85	55affecting an insureds right to receive benefits under any insurance policy or insurance contract
86	86	56providing insurance coverage for ambulance services. No term or provision of this section 3C
87	87	57shall create an entitlement on behalf of an insured to coverage for ambulance services if the
88	88	58insureds insurance policy or insurance contract provides no coverage for ambulance services.