California Health and Safety Code

§ 1371.55

HSC § 1371.55 Effective Jan 1, 2020Div. 2 · Ch. 2.2 · Art. 5

Statute text

(a)(1) Notwithstanding Section 1367.11, a health care service plan contract issued, amended, or renewed on or after January 1, 2020, shall provide that if an enrollee receives covered services from a noncontracting air ambulance provider, the enrollee shall pay no more than the same cost-sharing amount that the enrollee would pay for the same covered services received from a contracting air ambulance provider. This amount shall be referred to as the “in-network cost-sharing amount.”

(2)An enrollee shall not owe the noncontracting provider more than the in-network cost-sharing amount for services subject to this section. At the time of payment by the plan to the noncontracting provider, the plan shall inform the enrollee and the noncontracting provider of the in-network cost-sharing amount owed by the enrollee.

(b)The following shall apply for purposes of this section:

…

Legislative history

Added by Stats. 2019, Ch. 537, Sec. 2. (AB 651) Effective January 1, 2020.