Access to Emergency Medical Services Act of 1995 - Requires a health plan that provides any emergency services coverage to cover emergency services furnished to a plan enrollee without regard to: (1) whether the provider has an arrangement with the plan; and (2) prior authorization. Mandates prompt payment in a reasonable and appropriate amount and prohibits cost-sharing greater for hospital emergency services than for other settings. Requires specified measures relating to the timeliness of prior authorization determinations regarding needed care identified in initial evaluations. Prohibits plans from discouraging appropriate use of the 911 emergency telephone number or from denying coverage or payment for an item or service solely on the basis that an enrollee uses the number. Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require health maintenance organizations, competitive medical plans, and managed care plans to meet the requirements of this paragraph.
Allows State laws that provide protections exceeding those of this Act.
Provides for civil money penalties for violations.
Introduced in House
Introduced in House
Referred to the Committee on Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sponsor introductory remarks on measure. (CR E1417-1419)
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health and Environment.
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