Air ambulance services.

(1) Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires that health care service plan contracts and health insurance policies provide coverage for certain services and treatments, including emergency medical transportation services. This bill would require a health care service plan contract or a health insurance policy issued, amended, or renewed on or after January 1, 2020, to provide that if an enrollee, insured, or subscriber (individual) receives covered services from a noncontracting air ambulance provider, the individual shall pay no more than the same cost sharing that the individual would pay for the same covered services received from a contracting air ambulance provider, referred to as the in-network cost-sharing amount. The bill would provide that an individual would not owe the noncontracting provider more than the in-network cost-sharing amount for services. The bill would authorize a noncontracting provider to advance to collections only the in-network cost-sharing amount that the individual has failed to pay. The bill would authorize a health care service plan, health insurer, or provider to seek relief in any court for the purpose of resolving a payment dispute, and would not prohibit a provider from using a health care service plan's or health insurer's existing dispute resolution processes. Because a willful violation of the bill's requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. (2) Existing law, the Emergency Medical Air Transportation Act, effective until January 1, 2022, imposes a penalty of $4 until January 1, 2020, upon every conviction for a violation of the Vehicle Code or a local ordinance adopted pursuant to the Vehicle Code, other than a parking offense. The act requires the county or the court that imposed the fine to transfer the moneys collected pursuant to that act to the Treasurer for deposit into the Emergency Medical Air Transportation and Children's Coverage Fund. Under the act, moneys in the fund are made available, upon appropriation by the Legislature, to the State Department of Health Care Services for children's health care coverage and administrative costs relating to emergency medical air transportation provider payments. Existing law requires the assessed penalty to continue to be collected, administered, and distributed until exhausted or until June 30, 2021, whichever occurs first, and requires any remaining unexpended and unencumbered moneys in the fund to be transferred to the General Fund, to be available, upon appropriation by the Legislature, for specified purposes, including funding children's health care coverage. This bill would impose the penalty until July 1, 2020, and would extend the above-specified dates by six months. (3) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.