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House of Representatives
Session of 2013 - 2014 Regular Session


Posted: January 11, 2013 10:15 AM
From: Representative Bernie O'Neill
To: All House members
Subject: Emergency Medical Services Agency Billing
In the near future, I plan to introduce legislation to address the retention and recruitment needs of our emergency medical services by addressing the current billing practices for EMS.

Specifically, my proposal will amend Chapter 81 of Title 35 (Health and Safety), which governs the emergency medical services system. Under my proposal, whenever a health insurance company is presented with an “assignment of benefits” form signed by a patient, the insurance company will then be required to send the payment for services rendered directly to the emergency medical services agency if that agency is not in the insurance company’s network.

When an emergency medical services agency provides emergent care to a patient covered by health insurance with which the EMS agency does not participate, the insurer sends the reimbursement directly to the patient. The EMS agency is then forced to bill the patient directly. This causes long delays for the provider in receiving payment, creating a cash flow problem. More significantly, there are many times that patient fails to forward the reimbursement to the provider and they receive no payment at all.

Please join me in further securing the much needed funding our EMS community needs.

If you have any questions on this legislation, please contact Connie McClure in my Harrisburg office at 705-7170 or by e-mailing cmcclure@pahousegop.com.

Thank you for your consideration and support of this very important piece of legislation.

Introduced as HB179