‘‘(C) NONPARTICIPATING.—The term ‘non-
participating’ means, with respect to a health
care provider that provides health care items
and services to a participant or beneficiary
under group health plan, a health care provider
that is not a participating health care provider
with respect to such items and services.
‘‘(D) PARTICIPATING.—The term ‘partici-
pating’ means, with respect to a health care
provider that provides health care items and
services to a participant or beneficiary under
group health plan, a health care provider that
furnishes such items and services under a con-
tract or other arrangement with the plan.
‘‘(b) COVERAGE OF EMERGENCY AMBULANCE SERV-
ICES.—
‘‘(1) IN GENERAL.—If a group health plan pro-
vides any benefits with respect to ambulance services
and emergency services, the plan shall cover emer-
gency ambulance services (as defined in paragraph
(2))) furnished under the coverage under the same
terms and conditions under subparagraphs (A)
through (D) of subsection (a)(1) under which cov-
erage is provided for emergency services.
‘‘(2) EMERGENCY AMBULANCE SERVICES.—For
purposes of this subsection, the term ‘emergency
ambulance services’ means ambulance services (as
defined for purposes of section 1861(s)(7) of the So-
cial Security Act) furnished to transport an indi-
vidual who has an emergency medical condition (as
defined in subsection (a)(2)(A)) to a hospital for the
receipt of emergency services (as defined in sub-
section (a)(2)(B)) in a case in which the emergency
services are covered under the plan pursuant to sub-
section (a)(1) and a prudent layperson, with an av-
erage knowledge of health and medicine, could rea-
sonably expect that the absence of such transport
would result in placing the health of the individual
in serious jeopardy, serious impairment of bodily
function, or serious dysfunction of any bodily organ
or part.’’.
(B) CLERICAL AMENDMENT.—The table of
sections of such subchapter is amended by in-
serting after the item relating to section 9812
the following new item:
‘‘Sec. 9813. Standard relating to access to emergency services
and emergency ambulance services.’’.
(b) INDIVIDUAL HEALTH INSURANCE.—(1) Part B
of title XXVII of the Public Health Service Act is amend-
ed by inserting after section 2752 the following new sec-
tion:
‘‘SEC. 2753. STANDARD RELATING TO ACCESS TO EMER-
GENCY SERVICES AND EMERGENCY AMBU-
LANCE SERVICES.
‘‘(a) IN GENERAL.—The provisions of subsections (a)
and (b) of section 2707 shall apply to health insurance
coverage offered by a health insurance issuer in the indi-
vidual market in the same manner as they apply to health
insurance coverage offered by a health insurance issuer
in connection with a group health plan in the small or
large group market.
‘‘(b) NOTICE.—A health insurance issuer under this
part shall comply with the notice requirement under sec-
tion 714(b) of the Employee Retirement Income Security
Act of 1974 with respect to the requirements referred to
in subsection (a) as if such section applied to such issuer
and such issuer were a group health plan.’’.
(2) Section 2762(b)(2) of such Act (42 U.S.C.
300gg–62(b)(2)) is amended by striking ‘‘section 2751’’
and inserting ‘‘sections 2751 and 2753’’.
(c) EFFECTIVE DATES.—
(1) 
GROUP
HEALTH
PLANS
AND
GROUP
HEALTH INSURANCE COVERAGE.—Subject to para-
graph (3), the amendments made by subsection (a)
apply with respect to group health plans for plan
years beginning on or after January 1, 2000.
(2) INDIVIDUAL
HEALTH
INSURANCE
COV-
ERAGE.—The amendments made by subsection (b)
apply with respect to health insurance coverage of-
fered, sold, issued, renewed, in effect, or operated in
the individual market on or after such date.
(3) COLLECTIVE BARGAINING EXCEPTION.—In
the case of a group health plan maintained pursuant
to 1 or more collective bargaining agreements be-
tween employee representatives and 1 or more em-
ployers ratified before the date of enactment of this
Act, the amendments made subsection (a) shall not
apply to plan years beginning before the later of—
(A) the date on which the last collective
bargaining agreements relating to the plan ter-
minates (determined without regard to any ex-
tension thereof agreed to after the date of en-
actment of this Act), or
(B) January 1, 2000.
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining
agreement relating to the plan which amends the
plan solely to conform to any requirement added by
subsection (a) shall not be treated as a termination
of such collective bargaining agreement.
(4) LIMITATION ON ENFORCEMENT ACTIONS.—
No enforcement action shall be taken, pursuant to
the amendments made by this subsections (a) and
(b), against a group health plan or health insurance
issuer with respect to a violation of a requirement
imposed by such amendments, to the extent that vio-
lation or failure occurs before the date of issuance
of regulations issued in connection with such re-
quirement, if the plan or issuer has sought to com-
ply in good faith with such requirement.
(d) COORDINATION OF ADMINISTRATION.—The Sec-
retary of Labor, the Secretary of the Treasury, and the
Secretary of Health and Human Services shall ensure,
through the execution of an interagency memorandum of
understanding among such Secretaries, that—
(1) regulations, rulings, and interpretations
issued by such Secretaries relating to the same mat-
ter over which two or more such Secretaries have re-
sponsibility under the provisions of this Act (and the
amendments made thereby) are administered so as
to have the same effect at all times; and
(2) coordination of policies relating to enforcing
the same requirements through such Secretaries in