HOUSE DOCKET, NO. FILED ON: 10/15/2010
House . . . . . . . . . . . . . . . No.
5052
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Message from His Excellency the Governor returning with recommendation of amendment section 31 of the engrossed Bill making appropriations for the fiscal years 2010 and 2011 to provide for supplementing certain existing appropriations and for certain other activities and projects (see House, No. 5028).
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The Commonwealth of Massachusetts
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DEVAL L. PATRICK
GOVERNOR
TIMOTHY P. MURRAY
LIEUTENANT GOVERNOR
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Executive Department
State House
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Boston 02133
(617) 725-4000
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October 15, 2010
To the Honorable Senate and House of Representatives:
Pursuant to Article LVI, as amended by Article XC, Section 3 of the Amendments to the Constitution, I am returning to you for amendment Section 31 of House Bill No. 5028, “An Act Making Appropriations for the Fiscal Years 2010 and 2011 to Provide for Supplementing Certain Existing Appropriations and for Certain Other Activities and Projects.”
Section 31 requires insurers to reimburse ambulance companies directly for services rendered regardless of whether those companies are members of the insurers’ contracted networks. I am concerned about the impact of this section on health care costs because it lacks guidelines governing reasonable charges for ambulance services. Such guidelines are important to my Administration’s commitment to controlling health care costs and premiums.
For this reason, I recommend that Section 31 be amended by adding the following 3 subsections:-
(c) Payments to an ambulance service provider under subsection (b) shall be at a rate equal to the lower of the insurer’s usual and customary charge for the ambulance service rendered to the insured, or 3 times the then current published rate for the ambulance service rendered to the insured as established by the Centers for Medicare and Medicaid Services under Title XVIII of the Social Security Act (Medicare).
(d) An ambulance service provider receiving payment for an ambulance service in accordance with subsections (b) and (c) shall be deemed to have been paid in full for the ambulance service provided to the insured, and shall have no further right or recourse to further bill the insured for said ambulance
service with the exception of coinsurance, co-payments or deductibles for which the insured is responsible under the insured’s insurance policy or insurance contract.
(e) No term or provision of this section shall be construed as limiting or adversely affecting an insured’s right to receive benefits under any insurance policy or insurance contract providing insurance coverage for ambulance services. No term or provision of this section shall create an entitlement on behalf of an insured to coverage for ambulance services if the insured’s insurance policy or insurance contract provides no coverage for ambulance services.
Sincerely,
DEVAL L. PATRICK,
Governor.
