PRIA, Government Policy, Made Personal

Summary

Group health plans must report data about air ambulance claims to the federal government. The report is due 90 days after the end of the first calendar year that begins after the government issues its final rule under the No Surprises Act, and again 90 days after the end of the following year. Plans must break the claims data down by whether the flight was an emergency, what kind of organization ran the air ambulance program, whether the trip started in a rural or urban area, what type of aircraft was used, and whether the provider had a contract with the plan. The government can ask for other provider information too.

Title 26, §9823

Internal Revenue Code, Source: USLM XML via OLRC

(a)Each group health plan shall submit to the Secretary, jointly with the Secretary of Labor and the Secretary of Health and Human Services—

(1)not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in section 106(d) of the No Surprises Act, the information described in subsection (b) with respect to such plan year; and

(2)not later than the date that is 90 days after the last day of the calendar year immediately succeeding the plan year described in paragraph (1), such information with respect to such immediately succeeding plan year.

(b)For purposes of subsection (a), information described in this subsection, with respect to a group health plan is each of the following:

(1)Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors:

(A)Whether such services were furnished on an emergent or nonemergent basis.

(B)Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, independent program, or tribally operated program in Alaska.

(C)Whether the transport in which the services were furnished originated in a rural or urban area.

(D)The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services.

(E)Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such services under the plan or coverage, respectively.

(2)Such other information regarding providers of air ambulance services as the Secretary may specify.

Editorial Notes

References in Text

section 106(d) of the No Surprises Act, referred to in subsec. (a)(1), is section 106(d) of div. BB of Pub. L. 116–260, which is set out as a note under section 300gg–118 of Title 42, The Public Health and Welfare.

§9823 Air Ambulance Report Requirements

Summary

Title 26, §9823

Notes & Related Subsidiaries

Editorial Notes

References in Text

Citations & Metadata