Florida § 641.514 - Coverage for air ambulance services.

§ 641.514. Coverage for air ambulance services.

(1) As used in this section, the term: (a) “Air ambulance service” has the same meaning as provided in s. 401.23. (b) “Health maintenance organization” has the same meaning as provided in s. 641.19(12). (c) “Reasonable reimbursement” means reimbursement that considers the direct cost to provide the air ambulance transportation service to the subscriber, the operation of an air ambulance service by a county which operates entirely within a designated area of critical state concern as determined by the Department of Commerce, and in-network reimbursement established by the health maintenance organization for the specific contract. The term does not include the amount of billed charges for the cost of services rendered. (2) A health maintenance contract must require a health maintenance organization to provide reasonable reimbursement to an air ambulance service for covered nonemergency and emergency services provided to a subscriber in accordance with the coverage terms of the contract. Such reasonable reimbursement may be reduced only by applicable copayments, coinsurance, and deductibles. Payment in full by the subscriber of his or her applicable copayment, coinsurance, or deductible constitutes an accord and satisfaction of, and constitutes a release of, any claim for additional moneys owed by the subscriber to the health maintenance organization or to any person or entity in connection with the air ambulance service.