Mississippi HB 1168: Out-of-network ambulance service provider; revise minimum allowable reimbursement rate for certain situations.

Bill Text

H. B. No. 1168 *HR26/R1761* ~ OFFICIAL ~ G1/2
25/HR26/R1761
PAGE 1 (ENK\KW)

To: Insurance; Public Health
and Human Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2025

By: Representative Turner

HOUSE BILL NO. 1168

AN ACT TO AMEND SECTION 83-9-373, MISSISSIPPI CODE OF 1972, 1
TO REVISE THE MINIMUM ALLOWABLE REIMBURSEMENT RATE FOR AN 2
OUT-OF-NETWORK AMBULANCE SERVICE PROVIDER WHEN THE REIMBURSEMENT 3
RATES HAVE NOT BEEN CONTRACTED FOR; TO PROVIDE THAT SUCH MINIMUM 4
ALLOWABLE REIMBURSEMENT RATE SHALL BE THE LESSER OF ONE HUNDRED 5
TWENTY-FIVE PERCENT OF THE REIMBURSEMENT ALLOWED BY MEDICARE FOR 6
THE RESPECTIVE SERVICES ORIGINATING IN THE RESPECTIVE GEOGRAPHIC 7
AREA OR THE AMBULANCE SERVICE PROVIDER'S BILLED CHARGES; AND FOR 8
RELATED PURPOSES. 9
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 10
SECTION 1. Section 83-9-373, Mississippi Code of 1972, is 11
amended as follows: 12
83-9-373. (1) (a) The minimum allowable reimbursement rate 13
under any policy of accident and sickness insurance as defined by 14
Section 83-9-1 to an out-of-network ambulance service provider for 15
all covered services shall be the rates contracted between an 16
ambulance service provider and a county, municipality or special 17
purpose district or authority, or otherwise approved or 18
established by ordinance or regulation enacted by any such county, 19
municipality or special purpose district or authority in which the 20
covered healthcare services originated. 21

H. B. No. 1168 *HR26/R1761* ~ OFFICIAL ~
25/HR26/R1761
PAGE 2 (ENK\KW)
ST: Out-of-network ambulance service provider;
revise minimum allowable reimbursement rate for
certain situations.
(b) In the absence of rates provided in subsection (a), 22
the minimum allowable reimbursement rate to an out-of-network 23
ambulance service provider shall be the * * * lesser of: 24
(i) * * * One hundred twenty-five percent (125%) 25
of the reimbursement allowed by Medicare for the respective 26
services originating in the respective geographic area; or 27
(ii) The ambulance service provider's billed 28
charges. 29
(2) A payment made under this section shall be considered 30
payment in full for the covered services provided, except for any 31
copayment, coinsurance, deductible and other cost-sharing feature 32
amounts required to be paid by the enrollee. 33
(3) For purposes of this section, the term "ambulance 34
service provider" means a person or entity that provides ambulance 35
transportation and emergency medical services to a patient for 36
which a permit is required under Section 41-59-9. 37
(4) This section shall stand repealed on June 30, * * * 38
2027. 39
SECTION 2. This act shall take effect and be in force from 40
and after its passage. 41