North Dakota 2025-2026 Regular Session

North Dakota House Bill HB1322 Compare Versions

Version 1 (Old)

Version 2 (New)

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	1	+	25.0744.04000
2	2		Sixty-ninth
3	3		Legislative Assembly
4	4		of North Dakota
5	5		Introduced by
6	6		Representative Weisz
7	7		Senator Roers
8	8		A BILL for an Act to create and enact a new section to chapter 23-27 and a new section to
9	9		chapter 26.1-47 of the North Dakota Century Code, relating to ambulance service balanced
10	10		billing and provider reimbursement; to amend and reenact section 23-27-04.8 of the North
11	11		Dakota Century Code, relating to emergency medical services communication; to provide for a
12	12		legislative management study; and to provide an appropriation.
13	13		BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
14	14		SECTION 1. AMENDMENT. Section 23-27-04.8 of the North Dakota Century Code is
15	15		amended and reenacted as follows:
16	16		23-27-04.8. Emergency medical services operation communications.
17		-	The department may regulate the primary communications methods and protocols for
18		-	emergency medical services operations in a mannerwhile permitting secondary
19		-	communications through other devices, including cell phones. The regulations must be
20		-	consistent with the protocols established by the department of emergency services.
	17	+	The department shall use pagers as a communication method and may regulate the
	18	+	communications methods and protocols for emergency medical services operations in a
	19	+	manner consistent with the protocols established by the department of emergency services.
21	20		SECTION 2. A new section to chapter 23-27 of the North Dakota Century Code is created
22	21		and enacted as follows:
23	22		Balance billing prohibited - Enforcement.
24	23		1.For purposes of this section, "ambulance service provider" means a service entity
25	24		licensed under chapter 23 - 27 as a basic life support or advanced life support
26	25		ambulance service. The term does not include an air ambulance provider.
27	26		2.An ambulance service provider may not collect or bill more than the covered
28	27		individual's deductible, coinsurance, copayment, or other cost-sharing amount the
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	28	+	covered individual would be responsible for if services were provided by a participating
	29	+	ambulance service provider.
	30	+	Page No. 1 25.0744.04000
30	31		ENGROSSED HOUSE BILL NO. 1322
31	32		FIRST ENGROSSMENT
32		-	with ~~Conference Committee~~ Amendments
	33	+	with Senate Amendments
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	55	+	22 Sixty-ninth
54	56		Legislative Assembly
55		-	covered individual would be responsible for if services were provided by a participating
56		-	ambulance service provider.
57	57		SECTION 3. A new section to chapter 26.1-47 of the North Dakota Century Code is created
58	58		and enacted as follows:
59	59		Ambulance insurance coverage - Direct payment required - Determination of
60	60		reimbursement rate for out-of-network ambulance service providers.
61	61		1.As used in this section:
62	62		a."Ambulance service provider" means a service entity licensed under chapter
63	63		23 - 27 as a basic life support or advanced life support ambulance service. The
64	64		term does not include an air ambulance provider.
65	65		b."Covered person" means an individual eligible to receive coverage of covered
66	66		services by a health care insurer under a health benefit plan.
67	67		c."Covered services" means medically necessary patient care or transportation
68	68		provided by ambulance service providers.
69	69		d."Health care insurer" means an entity subject to state insurance regulation that
70	70		provides health benefit coverage in this state. The term includes:
71	71		(1)An insurance company;
72	72		(2)A health maintenance organization;
73	73		(3)A hospital or medical service corporation; and
74	74		(4)A risk-based provider organization.
75	75		e."Medicare reimbursement rate" means the reimbursement rate for a particular
76	76		health care service provided under the Health Insurance for the Aged and
77	77		Disabled Act, title XVIII of the federal Social Security Act of 1965 [42 U.S.C.
78	78		1395 et seq.], as amended.
79	79		2.All reimbursements made by a health care insurer for the provision of ambulance
80	80		services to a covered individual must be paid directly to the ambulance service
81	81		provider or the provider's designee.
82	82		3.If a covered person receives ambulance services from an out-of-network ambulance
83	83		service provider, the health care insurer shall pay the ambulance service provider the
84	84		lesser of:
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	85	+	a.Two hundred fifty percent of the Medicare reimbursement rate for the same
	86	+	service in the same geographic area; or
	87	+	b.The ambulance provider's billed charges.
	88	+	Page No. 2 25.0744.04000
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116	120		Legislative Assembly
117		-	a.Two hundred fifty percent of the Medicare reimbursement rate for the same
118		-	service in the same geographic area; or
119		-	b.The ambulance provider's billed charges.
120	121		4.Any rate the health care insurer pays under this section may not be required to include
121	122		the coinsurance, copayment, and deductible owed or already paid by the covered
122	123		person.
123	124		5.The insurance commissioner may adopt rules to implement and enforce this section.
124	125		SECTION 4. LEGISLATIVE MANAGEMENT STUDY - DELINQUENT BILLING
125	126		REIMBURSEMENT. During the 2025-26 interim, the legislative management shall consider
126	127		studying the feasibility and desirability of establishing a delinquent billing reimbursement grant
127	128		system for ambulance service providers. The study must include input from stakeholders,
128	129		including the insurance department, and a survey of ambulance service providers. The
129	130		legislative management shall report its findings and recommendations, together with any
130	131		legislation required to implement the recommendations, to the seventieth legislative assembly.
131	132		SECTION 5. APPROPRIATION - LEGISLATIVE COUNCIL - DELINQUENT BILLING
132	133		REIMBURSEMENT - ONE-TIME FUNDING. There is appropriated out of any moneys in the
133	134		general fund in the state treasury, not otherwise appropriated, the sum of $20,000, or so much
134	135		of the sum as may be necessary, to the legislative council for the purpose of contracting for
135	136		consulting services for the study provided for in section 3 of this Act, for the biennium beginning
136	137		July 1, 2025, and ending June 30, 2027. The appropriation provided in this section is a one-time
137	138		funding item.
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