Dec. 21, 2015
HARRISBURG – Legislation that Rep. Steve Barrar (R-Chester/Delaware) championed was signed into law yesterday. Act 84 of 2015 will extend the Children’s Health Insurance Program (CHIP) for two years and require insurance companies directly pay ambulance companies, rather than patients, for transport services.
“Act 84 provides the ambulance companies with the ability to receive funds earned and desperately needed by no longer expecting that patients will provide the payment that they currently receive from insurance companies,” Barrar said. “Even residents with the sincerest intentions may not pass the check along. People’s lives are so busy that it is best not to assume that they will be able to quickly handle yet another item on their to-do list.”
Under Act 84, if an EMS agency chooses to join a state registry, insurance companies would be required to pay directly to a non-network EMS agency for a service performed by that agency, as long as it was dispatched by a 911 or EMS dispatch center and provided medically necessary care. Currently, insurers send reimbursements to patients with the expectation they will pass the money on to the ambulance company, but that frequently does not happen.
If an EMS agency opts into this registry option, the agency will be prohibited from balance-billing patients for services provided. It can still recover a copay, deductible or co-insurance.
In addition to improving the payment system for services ambulance companies provide, Act 84 also extends CHIP for two years while transferring the initiative to the Department of Human Services for better coordination of care and cost-savings.
“CHIP has played a vital role in the care of Commonwealth children for nearly 25 years by offering no-cost or low-cost health care coverage,” Barrar said. “Because families rely on the services CHIP provides, it’s important to note that families and health care providers should not see any change in eligibility, co-payments, benefits or coverage.”
The change will allow better coordination of services, especially for families whose income levels fluctuate and children transition between CHIP and Medicaid, upward of 10,000 each year, and to identify more children who would benefit from coverage.
The law will take effect in January 2016.
Representative Stephen E. Barrar
160th District
Pennsylvania House of Representatives
Media Contact: Alison Evans
717.260.6206
aevans@pahousegop.com
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