Prohibit "balance billing" by ground ambulances
The legislation would modify existing Alabama insurance laws by preventing out-of-network ground ambulance providers from billing patients for amounts beyond the established minimum rate calculated as 325% of the Medicare reimbursement rate. This shift is intended to protect insured individuals from unexpected high bills and to streamline payment processes between insurers and providers. Insurers would also be required to pay ambulance services directly, not through the patient, further shielding consumers from balance billing.
House Bill 401 aims to address the issue of surprise billing in the context of ground ambulance services. Currently, when patients receive ambulance services from providers outside their insurer's network, they can be subject to balance billing, where the provider charges the insured individual for the remaining balance after insurance payment. This bill proposes to eliminate that practice by establishing a minimum reimbursement rate that insurers must pay out-of-network ambulance providers, which would be considered full payment for services rendered.
While proponents of HB401 argue that it will enhance consumer protection and provide clarity in billing practices, concerns have been raised regarding its potential impact on ambulance providers, especially those operating in high-cost areas. Some stakeholders fear that capping reimbursement rates could lead to decreased incentives for ambulance services, particularly those in rural or underserved areas, which may already struggle financially. Therefore, discussions around the bill highlight a tension between protecting consumers and ensuring the viability of emergency medical service providers.