Sec. 8.2. (a) If a health plan operator makes payment to a nonparticipating ambulance service provider according to section 8.1 of this chapter for ambulance service provided to a covered individual:

(1) the payment shall be considered payment in full for the ambulance service provided, except for any copayment, coinsurance, deductible, and other cost sharing amounts that the health plan requires the covered individual to pay; and

(2) the nonparticipating ambulance service provider is prohibited from billing the covered individual for any additional amount for the ambulance service provided.

     (b) The copayment, coinsurance, deductible, and other cost sharing amounts that a health plan requires a covered individual to pay in connection with ambulance service provided to the covered individual by a nonparticipating ambulance service provider shall not exceed the copayment, coinsurance, deductible, and other cost sharing amounts that the covered individual would be required to pay if the ambulance service had been provided to the covered individual by a participating ambulance service provider.

As added by P.L.163-2024, SEC.11.