View this article online: https://www.claimsjournal.com/news/west/2006/01/27/64713.htm
The National Association of Mutual Insurance Companies (NAMIC) will support a Colorado proposal to eliminate a requirement that auto insurance customers purchase compulsory coverage to pay for emergency medical care services typically paid by health insurance policies.
The proposal was offered Thursday as an amendment to SB 19, Mandated Emergency Medical Care Coverage, during a Colorado Senate Health and Human Services Committee Hearing.
The proposed program does not require consumers to purchase a new compulsory insurance coverage in order to lawfully operate a motor vehicle. The Division of Insurance program would provide reimbursement of uncompensated trauma care services provided by first responders and trauma physicians to trauma patients injured in a motor vehicle accident.
“The Emergency Responder and Trauma Care Reimbursement Program amendment offers a reasonable and pragmatic approach for assisting emergency responders and trauma care providers in collecting reimbursement for uncompensated emergency medical services, without requiring insurance consumers to purchase a mandatory emergency medical care coverage,” said Christian John Rataj, NAMIC’s western region state affairs manager.
“The amendment’s sponsor judiciously balanced the financial needs of the emergency medical services industry with the financial needs of insurance consumers,” Rataj continued. “The amendment offers a feasible solution to the concerns of the emergency medical services industry without creating an unnecessary and unreasonable economic burden for the insurance consumer.
“The original bill’s proponents argued that Colorado faced a trauma care and emergency medical services crisis because responders and providers were unable to timely collect reimbursements for medical services provided to consumers who do not have a health insurance policy available to promptly pay for services rendered. The Emergency Responder and Trauma Care Reimbursement Program could solve that problem.
“The proposed Emergency Responder and Trauma Care Reimbursement Program could have a positive impact on trauma care, because it sets forth practical and equitable guidelines to ensure that those providers that really need financial assistance are compensated by the fund.”
According to Rataj, the proposal has a number of provisions designed to protect against mismanagement and abuse of claims procedures. Specifically, the proposed amendment articulates criteria and qualifications that a provider must satisfy in order to be eligible for reimbursement from the fund; mandates that providers demonstrate that trauma services provided to the patient were medically necessity; and requires the program administrator to use insurance industry standards to determine the maximum allowable reimbursement amounts for providers.
The program would:
* create a public fund, paid for by a $10 annual assessment at the time of registration of a motor vehicle, to assist in the reimbursement of and subrogation for uncollected emergency responder and trauma care provider services;
* empower the Insurance Commissioner to appoint an administrator to oversee the program;
* implement a mechanism for prioritizing reimbursements to emergency responders and trauma care providers;
* establish an administrative process for evaluating and managing reimbursement claims, and
* institute a routine reporting procedure for the legislature to utilize in assessing the ongoing accomplishments of the program.