PRINTER'S NO. 2008
No. 1631 Session of 1987
INTRODUCED BY CAWLEY, TIGUE, STEIGHNER, GRUITZA, MAINE, BLAUM,
CAPPABIANCA, ARTY, HASAY, CHADWICK, E. Z. TAYLOR, SIRIANNI,
GODSHALL, G. SNYDER, GANNON, BIRMELIN AND DISTLER, JUNE 30,
1987
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, JUNE 30, 1987
AN ACT
1 Providing direct reimbursement to providers for medical
2 transportation services.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Medical transportation services reimbursement.
6 (a) General rule.--Every health care insurance plan that
7 offers coverage for medical transportation services shall
8 contain a provision providing for direct reimbursement to any
9 provider of covered medical transportation services if the
10 provider has not received payment for those services from any
11 other source. A health care insurer shall pay a medical
12 transportation provider directly, and a medical transportation
13 provider shall not demand payment from the insured except for
14 any unpaid portion of the provider's fee.
15 (b) Definition.--As used in this section, the term "health
16 care insurer" means any person, corporation or other entity that
17 offers administrative, indemnity or payment services for health
1 care in exchange for a premium or service charge under a program
2 of health care benefits, including, but not limited to, an
3 insurance company, association or exchange issuing health
4 insurance policies in this Commonwealth; a hospital plan
5 corporation, as defined in 40 Pa.C.S. Ch. 61 (relating to
6 hospital plan corporations); a professional health services plan
7 corporation as defined in 40 Pa.C.S. Ch. 63 (relating to
8 professional health services plan corporations); a health
9 maintenance organization; a preferred provider organization;
10 fraternal benefit societies; beneficial societies; and third-
11 party administrators. The term includes employers, labor unions
12 or health and welfare funds jointly or separately administered
13 by employers or labor unions that purchase or self-fund a
14 program of health care benefits for their employees or members
15 and their dependents.
16 Section 2. This act shall take effect January 1, 1988.
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