Dec. 21, 2015
HARRISBURG — Legislation, initiated and spearheaded by Rep. Bernie O’Neill (R-Bucks), which addresses the reimbursement needs of emergency medical services (EMS), was signed into law Sunday, Dec. 20 by the governor.
O’Neill’s proposal requires insurers to pay EMS claims directly to a non-participating EMS agency that has opted to register to receive direct pay along with specified conditions.
“Ambulance companies continue to struggle to survive and many are forced to close their doors due to financial hardship,” said O’Neill. “This legislation has been worked on in the House for 16 years and I have personally been working to get it passed for 12 years. It’s been a long time in the making, but we can now ensure participating EMS agencies receive prompt payment for their services, so they can continue to operate and provide critical patient care to our communities.”
Under Act 84, the insurer is required to send payment directly to the EMS provider of 911 emergency care if the service is considered medically necessary. The EMS agency must also have been properly dispatched by an approved 911 center.
“As a former volunteer fireman, I’ve seen many instances where insurers have sent reimbursement directly to the patient, forcing the EMS agency to bill the patient directly and causing long delays in payment,” said O’Neill.
Prior to the new law, if an individual required the services of an emergency service provider that was not a contracted provider, then the insurance company would send the payment for the claim directly to the individual, who may or may not forward the payment on to the emergency service provider.
“Ambulance companies provide a very necessary service to our communities,” said O’Neill. “This change will provide a more efficient model and one that offers greater adaptability, further securing the much-needed funding to meet the critical care needs of our EMS community. I appreciate my House and Senate colleagues’ and the governor’s support on this issue.”
Representative Bernie O’Neill
29th District
Pennsylvania House of Representatives
Media Contact: Abbey Haslam
717.260.6222
ahaslam@pahousegop.com
RepONeill.com