HB1312

This bill, known as the 'Transportation Benefit Manager Act,' establishes regulatory requirements for the relationships between ambulance providers, healthcare insurers, and transportation benefit managers in Arkansas. It mandates specific protocols for prior authorization, including banning prior authorization for emergency ground or air prehospital transport and requiring urgent inter-facility transport authorizations to be processed within 20 minutes or be deemed automatically approved. The bill sets a payment standard for authorized ambulance services at 250% of the Medicare Ambulance Fee Schedule (Rural Rate). It prohibits balance billing patients beyond their standard deductibles, copayments, or coinsurance. Furthermore, it protects approved claims from audit recoupment and prohibits the use of implementation costs as a justification for raising insurance premiums or reducing payments to providers. Finally, it grants the Insurance Commissioner the authority to create rules for implementation and enforcement under the Trade Practices Act.