87R5455 SMT-F
By: Oliverson H.B. No. 1460
A BILL TO BE ENTITLED
AN ACT
relating to regulation of air ambulance subscription providers by
the Texas Department of Insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle I, Title 8, Insurance Code, is amended
by adding Chapter 1654 to read as follows:
CHAPTER 1654. AIR AMBULANCE SUBSCRIPTIONS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 1654.001. DEFINITIONS. In this chapter:
(1) "Air ambulance" means a helicopter or fixed-wing
aircraft that is an emergency medical services vehicle as defined
by Section 773.003, Health and Safety Code.
(2) "Air ambulance subscription provider" means a
person who, directly or indirectly, including through an affiliated
entity or agreement with a third party, solicits membership
subscriptions, accepts applications, or charges membership fees
for a subscription program that:
(A) indemnifies a person against the cost of
emergency transportation in an air ambulance; and
(B) is required to secure a surety bond under
Section 773.011, Health and Safety Code.
Sec. 1654.002. BUSINESS OF INSURANCE. An air ambulance
subscription provider engages in the business of insurance.
Sec. 1654.003. COVERAGE MAY BE SECONDARY. Coverage of
transportation in an air ambulance by an air ambulance subscription
provider may be made secondary to an insurance policy or health
benefit plan in which the consumer is enrolled.
SUBCHAPTER B. CONSUMER ADVOCACY
Sec. 1654.051. INTERNET WEBSITE. (a) An air ambulance
subscription provider shall maintain an Internet website.
(b) An air ambulance subscription provider shall include on
its Internet website a section that is clearly marked "patient
portal" or "patient advocacy."
(c) The Internet website address to the patient portal or
patient advocacy section must be on each piece of communication
provided or made available to a consumer, including an Internet
website, brochure, letter, invoice, or billing statement.
(d) The patient portal or patient advocacy section of an air
ambulance subscription provider's Internet website must:
(1) be easy for a consumer to access;
(2) provide a layperson's explanation of what to
expect during the claims process; and
(3) contain clearly written and comprehensive
resources for consumers, including:
(A) frequently asked questions and answers;
(B) frequently used forms;
(C) information regarding the air ambulance
subscription provider's financial assistance program;
(D) contact information for the Emergency
Medical Services Compliance Unit of the Department of State Health
Services;
(E) information on how to file a complaint with
the department;
(F) contact information for the United States
Department of Transportation's Office of Aviation Consumer
Protection; and
(G) contact information for other health
consumer informational resources as prescribed by department rule.
Sec. 1654.052. E-MAIL ADDRESS AND TELEPHONE HOTLINE. (a) An
air ambulance subscription provider shall provide an e-mail address
and a dedicated telephone hotline number for consumers to submit
questions, complaints, and concerns.
(b) The e-mail address and telephone hotline number
required by this section must be listed on the air ambulance
subscription provider's Internet website and on each piece of
communication provided or made available to a consumer, including a
brochure, letter, invoice, or billing statement.
Sec. 1654.053. FINANCIAL ASSISTANCE. An air ambulance
subscription provider shall implement and maintain a financial
assistance program designed to provide assistance to consumers
experiencing financial hardship in resolving an outstanding
balance for air ambulance transportation.
Sec. 1654.054. DESIGNATED PERSONNEL. An air ambulance
subscription provider shall designate an appropriate number of
individuals to:
(1) address questions, complaints, or concerns
submitted to the e-mail address or telephone hotline described by
Section 1654.052 not later than three months after the date the
question, complaint, or concern is submitted;
(2) handle consumer disputes not later than three
months after the dispute is initiated; and
(3) address concerns or requests from a governmental
agency not later than three months after the concern or request is
submitted.
Sec. 1654.055. MANDATORY TRAINING. An air ambulance
subscription provider shall require annual consumer advocacy
training in accordance with department rule for all provider
personnel who have direct contact with consumers, patients, or
family members of consumers or patients.
Sec. 1654.056. REQUIRED DISCLOSURE. An air ambulance
subscription provider shall include the following statements in
12-point or larger bold type on each marketing, advertisement, or
contract document related to an air ambulance subscription:
(1) "If eligible and covered by Medicaid, a consumer
is covered for air ambulance services with no out-of-pocket cost.";
and
(2) "If eligible and covered by Medicare or a Medicare
supplement plan, a consumer may be covered for air ambulance
services and should consult a representative of the Medicare
program, the Medicare Advantage Plan, or the Medicare Supplemental
Plan to determine the level of existing coverage for air ambulance
services, the amount of out-of-pocket costs for those services, and
whether the Medicare plan provider recommends additional
supplemental insurance coverage."
SECTION 2. Section 773.011(e), Health and Safety Code, is
amended to read as follows:
(e) Except as provided by Chapter 1654, Insurance Code,
the [The] Insurance Code does not apply to a subscription program
established under this section.
SECTION 3. (a) The change in law made by this Act applies
only to an air ambulance subscription contract that is delivered,
issued for delivery, or renewed on or after September 1, 2022. A
contract delivered, issued for delivery, or renewed before
September 1, 2022, is governed by the law as it existed immediately
before the effective date of this Act, and that law is continued in
effect for that purpose.
(b) An air ambulance subscription provider is not required
to comply with Chapter 1654, Insurance Code, as added by this Act,
before September 1, 2022.
SECTION 4. This Act takes effect September 1, 2021.