Miss. Code § 83-9-NEW-004

Current through 5/14/2024

Section 83-9-NEW-004 - [Newly enacted section not yet numbered] [Effective 7/1/2024] [Mississippi Triage, Treat and Transport to Alternative Destination Act]

(1) This section shall be known and may be cited as the "Mississippi Triage, Treat and Transport to Alternative Destination Act."

(2)Definitions. As used in this section, the following terms shall be defined as provided in this subsection:

(a) "911 call" means a communication made on behalf of an enrollee indicating that the enrollee may need emergency medical services;

(b)

(i) "Alternative destination" means a lower-acuity facility that provides medical services, including, without limitation:

1. A federally qualified health center;

2. An urgent care center;

3. A physician's office or medical clinic, as chosen by the patient; and

4. A behavioral or mental health care facility, including, without limitation, a crisis stabilization unit and a diversion center.

(ii) "Alternative destination" does not include a:

1. Critical access hospital;

2. Dialysis center;

3. Hospital;

4. Private residence; or

5. Skilled nursing facility.

(c) "Ambulance service provider" means a person or entity that provides ambulance transportation and emergency medical services to a patient for which a permit is required under Section 41-59-9;

(d) "Enrollee" means an individual who is covered by any health benefit plan; and

(e) "Health benefit plan" means any such policy as defined by Section 83-63-3.

(3) Coverage for ambulance service to assess, triage and transport an enrollee to an alterative destination or treat in place. On and after July 1, 2024, any health benefit plan shall provide coverage for:

(a) An ambulance service to:

(i) Treat or assess an enrollee in place; or

(ii) Triage or triage and transport an enrollee to an alterative destination; or

(b) An encounter between an ambulance service and enrollee that results without transport of the enrollee.

(4) The coverage required under this section:

(a) Is subject to the initiation of ambulance service treatment as a result of a 911 call that is documented in the records of the ambulance service;

(b) Is subject to deductibles or co-payment requirements of the health benefit plan;

(c) Does not diminish or limit benefits otherwise allowable under a health benefit plan, even if the billing claims for medical or behavioral health services overlap in time that is billed by the ambulance service provider that is also providing care; and

(d) Is subject to any provisions of the health benefit plan that apply to other services covered by the health benefit plan.

(5) The reimbursement rate for an ambulance service provider whose operators assess, triage, treat or transport an enrollee to an alternative destination shall be not less than the minimum allowable reimbursement for advanced life support rate with mileage to the scene.

(6) This section shall apply to all contracts described in this section that are entered into or renewed on or after July 1, 2024.

Miss. Code § 83-9-NEW-004

Added by Laws, 2024, ch. TBD, HB 1489,§ 1, eff. 7/1/2024.