Amends TCA Title 56, Chapter 7 and Title 68, Chapter 140.
Tennessee SB1376 prohibits out-of-network ambulance service providers from balance billing enrollees of health benefit plans for emergency ambulance services starting July 1, 2025. The bill affects enrollees of health insurers and establishes that they satisfy their payment obligation by paying the lesser of the in-network cost-sharing amount, the provider's billed charges, or 325% of the Medicare rate for the service. Additionally, it mandates that health insurers treat these payments similarly to in-network services for deductible and out-of-pocket calculations and prohibits ambulance service organizations from requiring enrollees to waive rights under this bill.
Tennessee SB1376 prohibits out-of-network ambulance service providers from balance billing enrollees of health benefit plans for emergency ambulance services starting July 1, 2025. The bill affects enrollees of health insurers and establishes that they satisfy their payment obligation by paying the lesser of the in-network cost-sharing amount, the provider's billed charges, or 325% of the Medicare rate for the service. Additionally, it mandates that health insurers treat these payments similarly to in-network services for deductible and out-of-pocket calculations and prohibits ambulance service organizations from requiring enrollees to waive rights under this bill.
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