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42 U.S.C. § 300gg–118Air ambulance report requirements

submitted 82 years ago by Pub. L. 116-260 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 306 words · no verdicts yet

in plain englishAI-generated · not legal advice

Health plans must report detailed data on air ambulance claims to federal regulators. The first report covers the year after new rules take effect; a second covers the year after that. Data must be broken down by emergency status, program type, pickup location, aircraft type, and network status.

(a) In general Each group health plan and health insurance issuer must submit a report to the Secretary, jointly with the Secretaries of Labor and the Treasury, in two rounds: first, no later than 90 days after the end of the first calendar year that begins after a specific rule under section 106(d) of the No Surprises Act is finalized, covering that plan year; and second, no later than 90 days after the end of the following calendar year, covering that next plan year. (b) Information described Each report must include claims data for air ambulance services, broken down by whether the transport was emergent or non-emergent; whether the provider runs a hospital-owned or hospital-sponsored program, a municipality-sponsored program, a hospital-independent hybrid program, an independent program, or a tribally operated program in Alaska; whether the transport started in a rural or urban area; the type of aircraft used, such as a helicopter or fixed-wing plane; and whether the provider has a contract with the plan or issuer. The report must also include any other information about air ambulance providers that the Secretary decides to ask for.
the actual law source: uscode.house.gov ↗public domain
(a) In general

Each group health plan and health insurance issuer offering group or individual health insurance coverage shall submit to the Secretary, jointly with the Secretary of Labor and the Secretary of the Treasury—

(1)

not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in section 106(d) of the No Surprises Act, the information described in subsection (b) with respect to such plan year; and

(2)

not later than the date that is 90 days after the last day of the calendar year immediately succeeding the plan year described in paragraph (1), such information with respect to such immediately succeeding plan year.

(b) Information described

For purposes of subsection (a), information described in this subsection, with respect to a group health plan or a health insurance issuer offering group or individual health insurance coverage, is each of the following:

(1)

Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors:

(A)

Whether such services were furnished on an emergent or nonemergent basis.

(B)

Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, independent program, or tribally operated program in Alaska.

(C)

Whether the transport in which the services were furnished originated in a rural or urban area.

(D)

The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services.

(E)

Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such services under the plan or coverage, respectively.

(2)

Such other information regarding providers of air ambulance services as the Secretary may specify.

Source credit: (July 1, 1944, ch. 373, title XXVII, § 2799A–8, as added Pub. L. 116–260, div. BB, title I, § 106(b)(1), Dec. 27, 2020, 134 Stat. 2852.)

history & why it existsrecord from the source credit
  • 1944Enacted · Pub. L. 116-260 · 134 Stat. 2852

A history note hasn’t been published yet. The record shows enactment by Pub. L. 116-260 on 1944-07-01.

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