MS Triage, Treat and Transport to Alternative Destination Act; revise provisions related to.

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To: Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representative Deweese

COMMITTEE SUBSTITUTE
FOR
HOUSE BILL NO. 1657

AN ACT TO AMEND SECTION 83-9-371, MISSISSIPPI CODE OF 1972, 1
TO AUTHORIZE THE USE OF TELEMEDICINE WHEN TREATING OR ASSESSING AN 2
ENROLLEE IN A HEALTH BENEFIT PLAN IN PLACE; TO AMEND SECTION 3
83-9-373, MISSISSIPPI CODE OF 1972, TO REVISE THE MINIMUM 4
ALLOWABLE REIMBURSEMENT RATE FOR AN OUT-OF-NETWORK AMBULANCE 5
SERVICE PROVIDER WHEN THE REIMBURSEMENT RATES HAVE NOT BEEN 6
CONTRACTED FOR; TO REQUIRE THE DEPARTMENT OF INSURANCE TO PUBLISH 7
THE CONTRACTED RATES; TO PROVIDE WHAT MUST BE INCLUDED IN AN 8
EXPLANATION OF BENEFITS DOCUMENT REGARDING THE AMBULANCE SERVICE 9
PROVIDER'S CHARGES FOR CERTAIN PURPOSES; TO PROVIDE THAT AN 10
AMBULANCE SERVICE PROVIDER SHALL BE PAID IN ACCORDANCE WITH THE 11
ASSIGNMENT OF BENEFITS; TO REQUIRE THE COMMISSIONER OF INSURANCE 12
TO ENFORCE; AND FOR RELATED PURPOSES. 13
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 14
SECTION 1. Section 83-9-371, Mississippi Code of 1972, is 15
amended as follows: 16
83-9-371. (1) This section shall be known and may be cited 17
as the "Mississippi Triage, Treat and Transport to Alternative 18
Destination Act." 19
(2) As used in this section, the following terms shall be 20
defined as provided in this subsection: 21
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(a) "911 call" means a communication made on behalf of 22
an enrollee indicating that the enrollee may need emergency 23
medical services; 24
(b) (i) "Alternative destination" means a lower-acuity 25
facility that provides medical services, including, without 26
limitation: 27
1. A federally qualified health center; 28
2. An urgent care center; 29
3. A physician's office or medical clinic, as 30
chosen by the patient; and 31
4. A behavioral or mental health care 32
facility, including, without limitation, a crisis stabilization 33
unit and a diversion center. 34
(ii) "Alternative destination" does not include a: 35
1. Critical access hospital; 36
2. Dialysis center; 37
3. Hospital; 38
4. Private residence; or 39
5. Skilled nursing facility. 40
(c) "Ambulance service provider" means a person or 41
entity that provides ambulance transportation and emergency 42
medical services to a patient for which a permit is required under 43
Section 41-59-9; 44
(d) "Enrollee" means an individual who is covered by 45
any health benefit plan; and 46
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(e) "Health benefit plan" means any such policy as 47
defined by Section 83-63-3. 48
(3) Coverage for ambulance service to assess, triage and 49
transport an enrollee to an alterative destination or treat in 50
place. On and after July 1, * * * 2026, any health benefit plan 51
shall provide coverage for: 52
(a) An ambulance service to: 53
(i) Treat or assess an enrollee in place, which 54
treatment or assessment may be made with the use of telemedicine 55
as defined in Section 83-9-351; or 56
(ii) Triage or triage and transport an enrollee to 57
an alterative destination; or 58
(b) An encounter between an ambulance service and 59
enrollee that results without transport of the enrollee. 60
(4) The coverage required under this section: 61
(a) Is subject to the initiation of ambulance service 62
treatment as a result of a 911 call that is documented 63
in the records of the ambulance service; 64
(b) Is subject to deductibles or co-payment 65
requirements of the health benefit plan; 66
(c) Does not diminish or limit benefits otherwise 67
allowable under a health benefit plan, even if the billing claims 68
for medical or behavioral health services overlap in time that is 69
billed by the ambulance service provider that is also providing 70
care; and 71
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(d) Is subject to any provisions of the health benefit 72
plan that apply to other services covered by the health benefit 73
plan. 74
(5) The reimbursement rate for an ambulance service provider 75
whose operators assess, triage, treat or transport an enrollee to 76
an alternative destination shall be not less than the minimum 77
allowable reimbursement for advanced life support rate with 78
mileage to the scene. 79
(6) This section shall apply to all contracts described in 80
this section that are entered into or renewed on or after July 81
1, * * * 2026. 82
SECTION 2. Section 83-9-373, Mississippi Code of 1972, is 83
amended as follows: 84
83-9-373. (1) (a) The minimum allowable reimbursement rate 85
under any policy of accident and sickness insurance as defined by 86
Section 83-9-1 to an out-of-network ambulance service provider for 87
all covered services shall be the rates contracted between an 88
ambulance service provider and a county, municipality or special 89
purpose district or authority, or otherwise approved or 90
established by ordinance or regulation enacted by any such county, 91
municipality or special purpose district or authority in which the 92
covered healthcare services originated. The Department of 93
Insurance shall publish such rates on its website within ten (10) 94
days of the ambulance service provider and a county, municipality 95
or special purpose district or authority executing a contract that 96
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establishes the rates, or within ten (10) days of the approval or 97
establishment of an ordinance or regulation enacted by the county, 98
municipality or special purpose district or authority that 99
establishes the rates. 100
(b) In the absence of rates provided in subsection (a), 101
the minimum allowable reimbursement rate to an out-of-network 102
ambulance service provider shall be the * * * lesser of: 103
(i) * * * Two hundred percent (200%) of the 104
reimbursement allowed by Medicare for the respective services 105
originating in the respective geographic area; or 106
(ii) The ambulance service provider's billed 107
charges; however, if the rates described in subparagraph (i) of 108
this paragraph (b) are the lesser rates, whether or not the payor 109
pays such lesser rates, the ambulance service provider's billed 110
charges must be included in the explanation of benefits 111
documenting the allowed payment amount and deemed to be the amount 112
of payment allowed for each service for purposes of the emergency 113
ambulance services provisions of Section 43-13-117. 114
(2) A payment made under this section shall be considered 115
payment in full for the covered services provided, except for any 116
copayment, coinsurance, deductible and other cost-sharing feature 117
amounts required to be paid by the enrollee. 118
(3) For purposes of this section, the term "ambulance 119
service provider" means a person or entity that provides ambulance 120
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ST: MS Triage, Treat and Transport to
Alternative Destination Act; revise provisions
related to.
transportation and emergency medical services to a patient for 121
which a permit is required under Section 41-59-9. 122
(4) The ambulance service provider must be paid in 123
accordance with the assignment of benefits as provided in law, and 124
the Commissioner of Insurance shall enforce the provisions of this 125
section. 126
( * * *5) This section shall stand repealed on June 127
30, * * * 2027. 128
SECTION 3. This act shall take effect and be in force from 129
and after its passage. 130