(a) (1) The minimum allowable reimbursement rate under any health benefit plan issued by a healthcare insurer to a participating ground ambulance service provider or an out-of-network ground ambulance service provider shall be at the rates approved or contracted between the ambulance service provider and the local government entity as provided for in § 14-266-105.(2) On and after July 1, 2025, in the absence of rates set as provided under subdivision (a)(1) of this section, the minimum allowable rate of reimbursement under a health benefit plan issued by a healthcare insurer shall be the lesser of:(A) Three hundred twenty-five percent (325%) of the Medicare Ambulance Fee Schedule, Arkansas Rural Rate, as established by the Centers for Medicare & Medicaid Services at the time of the date of service for the same service provided; or(B) The provider's billed charges.
(1) The minimum allowable reimbursement rate under any health benefit plan issued by a healthcare insurer to a participating ground ambulance service provider or an out-of-network ground ambulance service provider shall be at the rates approved or contracted between the ambulance service provider and the local government entity as provided for in § 14-266-105.
(2) On and after July 1, 2025, in the absence of rates set as provided under subdivision (a)(1) of this section, the minimum allowable rate of reimbursement under a health benefit plan issued by a healthcare insurer shall be the lesser of:(A) Three hundred twenty-five percent (325%) of the Medicare Ambulance Fee Schedule, Arkansas Rural Rate, as established by the Centers for Medicare & Medicaid Services at the time of the date of service for the same service provided; or(B) The provider's billed charges.
(A) Three hundred twenty-five percent (325%) of the Medicare Ambulance Fee Schedule, Arkansas Rural Rate, as established by the Centers for Medicare & Medicaid Services at the time of the date of service for the same service provided; or
(B) The provider's billed charges.
(b) A payment made under this section shall be considered payment in full for the covered services provided, except for any copayment, coinsurance, deductible, and other cost-sharing feature amounts required to be paid by the enrollee.
(c) (1) A healthcare insurer shall remit payment within thirty (30) days for ambulance services directly to the ground ambulance service provider.(2) A healthcare insurer shall not send payment to an enrollee.
(1) A healthcare insurer shall remit payment within thirty (30) days for ambulance services directly to the ground ambulance service provider.
(2) A healthcare insurer shall not send payment to an enrollee.