A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Plain English Breakdown

The official source material does not provide detailed information on the impact of the bill on non-emergency medical situations or its final status after passing both chambers.

Indiana Bill HB1370: Emergency Medical Services Coverage

HB1370 amends Indiana's insurance laws to remove prior authorization requirements for ambulance and urgent/emergent response services within specific timeframes, ensuring quicker coverage for emergency medical services.

What This Bill Does

• It prohibits utilization review entities from requiring prior authorization for ambulance services provided to a covered individual by a nonparticipating provider within 12 hours of the request.
• It also prevents utilization review entities from requiring prior authorization for emergent or urgent response services provided in good faith within 24 hours of the request.
• Insurance policies must provide reimbursement for emergency medical services performed during a 911 call or any other method used to summon help.
• Policies must also cover emergency medical services when a physician determines they are necessary.
• It removes certain code provisions addressing advanced life support services.

Who It Names or Affects

• People who need ambulance and urgent/emergent response services in emergencies.
• Insurance companies that provide accident and sickness insurance policies.

Terms To Know

Utilization review entity

A company or group that checks if medical treatments are necessary before paying for them through insurance.

Prior authorization

When an insurance company needs to approve a treatment or service before it can be used and paid for by the policy.

Limits and Unknowns

• The bill does not specify what happens if emergency services are provided outside of the time limits mentioned.
• It is unclear how this will affect non-emergency medical situations covered under insurance policies.
• This bill has passed both chambers but its final status and any executive action remain unknown.

Official Summary Text

A BILL FOR AN ACT to amend the Indiana Code concerning insurance.
Payment of claims for emergency services.

Current Bill Text

A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Payment of claims for emergency services.

Prohibits a utilization review entity from requiring prior authorization for ambulance services provided: (1) to a covered individual; (2) by a nonparticipating ambulance service provider; and (3) within 12 hours after the ambulance services are requested. Prohibits a utilization review entity from requiring prior authorization for emergent response services or urgent response services that are provided: (1) to a covered individual; (2) in good faith; and (3) within 24 hours after the emergent response services or urgent response services are requested. Provides that a policy of accident and sickness insurance that provides coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided during a response initiated through the 911 system or an equivalent telephone number, a texting system, or any other method of summoning emergency medical services. Provides that a policy of accident and sickness insurance that provides coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided when an individual is determined to require emergency medical services by a physician. Provides that an individual contract and a group contract that provide coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided during a response initiated through the 911 system or an equivalent telephone number, a texting system, or any other method of summoning emergency medical services. Provides that an individual contract and a group contract that provide coverage for emergency medical services must provide reimbursement for emergency medical services that are, among other things, performed or provided when an individual is determined to require emergency medical services by a physician. Repeals certain code provisions addressing advanced life support services.