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.