Ground Ambulance Service Rates & Billing
One of the significant impacts of HB 1218 is its provision that out-of-network ambulance services cannot bill a covered person for any outstanding balance beyond what their insurer pays, excluding applicable coinsurance, deductibles, or copayments. This change is meant to protect consumers from unexpected financial burdens associated with emergency and non-emergency ambulance transport services. It also mandates that insurance carriers must reimburse ambulance services based on the rates reported by the political subdivisions or at a set percentage of federal reimbursement rates if such reports are not provided.
House Bill 1218 addresses the costs associated with the provision of ground ambulance services in Colorado. The legislation allows political subdivisions or ambulance services contracted to provide such services to submit their established rates to the Colorado Division of Insurance. These rates will then be published on a public-facing database maintained by the Division, ensuring transparency regarding the costs of ambulance services across the state. It aims to standardize how out-of-network ambulance services are billed and reimbursed.
While the bill aims to reduce the financial burden on consumers, it may face contention due to its implications for both ambulance services and insurance providers. Ambulance services may have concerns about the established reimbursement rates, potentially arguing that they do not adequately cover operational costs. Additionally, insurers and other stakeholders might express concerns regarding the administrative burden of tracking and adhering to these new billing guidelines. The legislation's requirement for continued oversight and possible adjustments based on market conditions could lead to debates among various interest groups as the bill moves forward.