Ground ambulance services; prohibit out-of-network providers from balance billing
If enacted, HB469 will significantly impact state laws by changing the way health insurers handle payments to out-of-network ground ambulance services. Insurers will be required to pay these providers directly, rather than billing the covered individuals for any balance. This legislation aims to simplify the reimbursement process and ensure patients are not financially burdened by out-of-network charges, particularly during emergencies when they may not have a choice of provider.
House Bill 469 seeks to address the issue of surprise billing for ground ambulance services, particularly focusing on out-of-network providers. Under current law, these providers can bill patients for balance amounts after receiving payment from an insurer. HB469 aims to prohibit this practice by establishing that health insurers must pay a minimum reimbursement rate to out-of-network emergency medical service providers. This rate is set at a multiplier of the Medicare reimbursement amount, thereby protecting patients from unexpected costs associated with out-of-network ambulance transportation.
The bill acknowledges that existing practices of surprise billing can create financial hardships for patients in urgent situations. While supporters argue that HB469 is a necessary reform to protect consumers, there may be pushback from insurance companies or providers who may be concerned about the financial implications of mandated reimbursement rates. This potential contention centers around the balance of protecting consumer rights while maintaining fair practices within the insurance and healthcare sectors.