Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1159

Introduced
2/27/25  

Caption

Relative to payments for use of ambulance services

Impact

The bill mandates that insurers are required to compensate ambulance service providers directly for emergency services provided to insured individuals. This provision aims to streamline the payment process and mitigate potential delays that might arise when an ambulance service provider does not have a direct contract with the relevant insurer. By establishing clear payment requirements, H1159 enhances the likelihood that ambulance services will be adequately reimbursed, regardless of existing contractual obligations between the insurers and service providers.

Summary

House Bill 1159 proposes amendments to Chapter 176D of the General Laws, specifically targeting payments related to the use of ambulance services in the Commonwealth of Massachusetts. This legislation aims to ensure that insured individuals receive timely and appropriate payment for emergency ambulance services rendered, even if the service provider is not contracted with the insurer. The bill defines essential terms such as 'ambulance service provider', 'emergency ambulance services', and details the responsibilities of insurers in the event of service delivery.

Contention

Notably, the bill addresses a critical issue surrounding patient care and insurance logistics. One potential point of contention lies in the provisions that enable payment for delivered services without requiring an assignment of benefits from the insured, thereby allowing for direct payment to service providers. This may raise concerns from insurers regarding the impact on their operational process and liability, as they could be compelled to pay for services rendered independent of an insured’s specific agreements. Additionally, the restriction of further billing to the insured by ambulance service providers post-payment might invoke discussion on the fairness and coverage scope of such arrangements.

Companion Bills

No companion bills found.

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