1| SENATE FLOOR VERSION | | March 6, 2025 | 2| | | | 3|SENATE BILL NO. 1036 By: Rader of the Senate | | | 4| and | | | 5| Townley of the House | | | 6| | | | 7| | | | 8| An Act relating to ambulance service; creating the | | Oklahoma Triage, Treat, and Transport to Alternative | 9| Destination Act; providing short title; defining | | terms; requiring coverage for certain services; | 10| providing certain limitations; providing for | | noncodification; providing for codification; and | 11| providing an effective date. | | | 12| | | | 13| | | | 14|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 15| SECTION 1. NEW LAW A new section of law not to be | | | 16|codified in the Oklahoma Statutes reads as follows: | | | 17| This act may be known and cited as the "Oklahoma Triage, Treat, | | | 18|and Transport to Alternative Destination Act". | | | 19| SECTION 2. NEW LAW A new section of law to be codified | | | 20|in the Oklahoma Statutes as Section 6060.11c of Title 36, unless | | | 21|there is created a duplication in numbering, reads as follows: | | | 22| A. As used in this act: | | | 23| | | | 24| | | | arsid3087570 SENATE FLOOR VERSION - SB1036 SFLR Page 1 ___________________________________________________________________________
1| 1. "9-1-1 call" means a communication made on behalf of an | | | 2|enrollee indicating that the enrollee may need emergency medical | | | 3|services; | | | 4| 2. a. "Alternative destination" means a lower-acuity | | | 5| facility that provides medical services, including, | | | 6| but not limited to: | | | 7| (1) a Federally Qualified Health Center, | | | 8| (2) an urgent care center, | | | 9| (3) a physician's office or medical clinic, or | | | 10| (4) a behavioral or mental health care facility, | | | 11| including, but not limited to, a crisis | | | 12| stabilization unit and a diversion center. | | | 13| b. Alternative destination does not include: | | | 14| (1) a dialysis center, | | | 15| (2) a hospital, | | | 16| (3) a private residence, or | | | 17| (4) a skilled nursing facility; | | | 18| 3. "Ambulance service" has the same meaning as provided by | | | 19|Section 1-2503 of Title 63 of the Oklahoma Statutes; | | | 20| 4. "Enrollee" means an individual who is covered by any health | | | 21|benefit plan; and | | | 22| 5. "Health benefit plan" means any such policy as provided by | | | 23|Section 4405.1 of Title 36 of the Oklahoma Statutes. | | | 24| | | | arsid3087570 SENATE FLOOR VERSION - SB1036 SFLR Page 2 ___________________________________________________________________________
1| B. On and after January 1, 2026, any insurer that offers, | | | 2|issues, or renews a health benefit plan in this state shall provide | | | 3|coverage for: | | | 4| 1. Services provided by an ambulance service provider to: | | | 5| a. treat an enrollee in place, or | | | 6| b. triage, treat, or transport an enrollee to an | | | 7| alternative destination; and | | | 8| 2. An encounter between an ambulance service and enrollee that | | | 9|results in no transport of the enrollee. | | | 10| C. The coverage under this section: | | | 11| 1. Is subject to the initiation of ambulance service treatment | | | 12|as a result of a 9-1-1 call that is documented in the records of the | | | 13|ambulance service; | | | 14| 2. Is subject to health benefit plan deductibles or copayment | | | 15|requirements; | | | 16| 3. Does not diminish or limit benefits otherwise allowable | | | 17|under a health benefit plan, even if the billing claims for medical | | | 18|or behavioral health services overlap in time that is billed by the | | | 19|ambulance service that is also providing care; and | | | 20| 4. Is subject to any health benefit plan provision that applies | | | 21|to other services covered by the health benefit plan. | | | 22| D. The reimbursement rate for an ambulance service whose | | | 23|operators triage, treat, and transport an enrollee to an alternative | | | 24|destination shall not be less than the minimum allowable | | | arsid3087570 SENATE FLOOR VERSION - SB1036 SFLR Page 3 ___________________________________________________________________________
1|reimbursement rate for advanced life support with mileage to the | | | 2|scene. | | | 3| E. This act shall apply to all contracts subject to this | | | 4|section that are entered into or renewed on or after January 1, | | | 5|2026. | | | 6| SECTION 3. This act shall become effective November 1, 2025. | | | 7|COMMITTEE REPORT BY: COMMITTEE ON BUSINESS AND INSURANCE | |March 6, 2025 - DO PASS | 8| | | | 9| | | | 10| | | | 11| | | | 12| | | | 13| | | | 14| | | | 15| | | | 16| | | | 17| | | | 18| | | | 19| | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | arsid3087570 SENATE FLOOR VERSION - SB1036 SFLR Page 4