AB50,2904 Section 2904. 609.714 of the statutes is created to read:

AB50,1429,22 609.714 Substance abuse counselor coverage. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (8).

AB50,2905 Section 2905. 609.718 of the statutes is created to read:

AB50,1430,2 609.718 Dental therapist coverage. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.87 (4e).

AB50,2906 Section 2906. 609.719 of the statutes is created to read:

AB50,1430,6 609.719 Coverage for telehealth services. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.871.

AB50,2907 Section 2907. 609.74 of the statutes is created to read:

AB50,1430,9 609.74 Coverage of infertility services. Defined network plans and preferred provider plans are subject to s. 632.895 (15m).

AB50,2908 Section 2908. 609.815 of the statutes is created to read:

AB50,1430,13 609.815 Exemption from prior authorization requirements. Limited service health organizations, preferred provider plans, and defined network plans are subject to any rules promulgated by the commissioner under s. 632.848.

AB50,2909 Section 2909. 609.823 of the statutes is created to read:

AB50,1430,17 609.823 Coverage without prior authorization for inpatient mental health services. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.891.

AB50,2910 Section 2910. 609.825 of the statutes is created to read:

AB50,1430,20 609.825 Coverage of emergency ambulance services. (1) In this section:

AB50,1430,21 (a) “Ambulance service provider” has the meaning given in s. 256.01 (3).

AB50,1431,2 (b) “Self-insured governmental plan” means a self-insured health plan of the state or a county, city, village, town, or school district that has a network of participating providers and imposes on enrollees in the self-insured health plan different requirements for using providers that are not participating providers.

AB50,1431,7 (2) A defined network plan, preferred provider plan, or self-insured governmental plan that provides coverage of emergency medical services shall cover emergency ambulance services provided by an ambulance service provider that is not a participating provider at a rate that is not lower than the greatest rate that is any of the following:

AB50,1431,9 (a) A rate that is set or approved by a local governmental entity in the jurisdiction in which the emergency ambulance services originated.

AB50,1431,15 (b) A rate that is 400 percent of the current published rate for the provided emergency ambulance services established by the federal centers for medicare and medicaid services under title XVIII of the federal Social Security Act, 42 USC 1395 et seq., in the same geographic area or a rate that is equivalent to the rate billed by the ambulance service provider for emergency ambulance services provided, whichever is less.

AB50,1431,18 (c) The contracted rate at which the defined network plan, preferred provider plan, or self-insured governmental plan would reimburse a participating ambulance service provider for the same emergency ambulance services.

AB50,1432,2 (3) No defined network plan, preferred provider plan, or self-insured governmental plan may impose a cost-sharing amount on an enrollee for emergency ambulance services provided by an ambulance service provider that is not a participating provider at a rate that is greater than the requirements that would apply if the emergency ambulance services were provided by a participating ambulance service provider.

AB50,1432,6 (4) No ambulance service provider that receives reimbursement under this section may bill an enrollee for any additional amount for emergency ambulance services except for any copayment, coinsurance, deductible, or other cost-sharing responsibilities required to be paid by the enrollee.

AB50,1432,8 (5) For purposes of this section, “emergency ambulance services” does not include air ambulance services.

AB50,2911 Section 2911. 609.83 of the statutes is amended to read:

AB50,1432,13 609.83 Coverage of drugs and devices; application of payments. Limited service health organizations, preferred provider plans, and defined network plans are subject to ss. 632.853, 632.861, 632.862, and 632.895 (6) (b), (16t), and (16v).

AB50,2912 Section 2912. 609.847 of the statutes is created to read:

AB50,1432,17 609.847 Preexisting condition discrimination and certain benefit limits prohibited. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.728.

AB50,2913 Section 2913. 611.11 (4) (a) of the statutes is amended to read:

AB50,1432,20 611.11 (4) (a) In this subsection, “municipality” has the meaning given in s. 345.05 (1) (c), but also includes any transit authority created under s. 66.1039.