Prohibit "balance billing" by out-of-network ground ambulances
Impact
The introduction of SB52 could significantly alter current state laws regarding ambulance services and billing practices. By establishing regulations that limit out-of-network charges, the bill would not only protect patients from excessive hospital bills but also create a more transparent billing environment. This could lead to a broader reform in how out-of-network healthcare services are billed and may encourage more providers to align with in-network agreements, thereby improving overall healthcare accessibility for patients.
Summary
Senate Bill 52 (SB52) seeks to prohibit 'balance billing' practices by out-of-network ground ambulances. Balance billing occurs when a provider bills a patient for the difference between what the patient’s insurance covers and the total amount charged by the provider for services rendered. This practice has been a source of financial strain for many patients who often inadvertently receive services from out-of-network providers, especially in emergency situations. SB52 aims to provide protections to consumers by ensuring that they are not liable for payment exceeding what their health insurance covers for emergency ambulance services.
Contention
Despite the potential benefits, SB52 may face contention from various stakeholders in the healthcare industry. Insurance companies may raise concerns over potential financial impacts linked to increased coverage requirements. Additionally, ambulance service providers could argue that the regulation may limit their revenue potential, particularly for those that rely on balance billing to cover service costs. As discussions continue, it is likely that debates will revolve around finding a balance between patient protection and the fiscal realities for providers and insurers.
An Act Requiring Health Insurance Coverage For Medically Necessary Ambulance Services At An In-network Level And Prohibiting Balance Billing For Such Services.
Relating to prohibited balance billing and an independent dispute resolution program for out-of-network coverage under certain managed care plans; authorizing a fee.
Relating to prohibited balance billing and an independent dispute resolution program for out-of-network coverage under certain managed care plans; authorizing a fee.
Provides for balance billing by and reimbursement of covered health services provided by out-of-network emergency ambulance services. (8/1/23) (EN INCREASE SG EX See Note)