New rules prevent out-of-network ambulance services from balance billing patients

House Bill 1088, introduced in the Colorado State Legislature on April 16, 2025, aims to reform the way out-of-network ambulance services are billed and reimbursed, addressing a growing concern over surprise medical bills. The bill establishes that payments made by insurance carriers for ambulance services will be considered full payment, except for any required coinsurance, deductible, or copayment from the patient. This provision seeks to protect consumers from unexpected charges when they receive emergency services from out-of-network providers.

Key provisions of the bill include a prohibition on out-of-network ambulance services from billing patients for any outstanding balances not covered by their insurance, except for the aforementioned cost-sharing amounts. Additionally, the bill allows for voluntary negotiations between carriers and out-of-network services regarding reimbursement rates, promoting flexibility while ensuring consumer protection.

Debate surrounding House Bill 1088 has highlighted concerns from both sides. Supporters argue that the legislation is crucial for safeguarding patients from financial distress during emergencies, while opponents, including some ambulance service providers, worry that the bill could undermine their financial viability by limiting reimbursement rates.

The implications of this bill are significant, as it not only addresses the immediate financial burdens on patients but also sets a precedent for how emergency medical services are billed in the future. Experts suggest that if passed, this legislation could lead to broader reforms in the healthcare billing system, potentially influencing similar measures in other states.

As the bill moves through the legislative process, stakeholders are closely monitoring its progress, anticipating that it could reshape the landscape of emergency medical billing in Colorado and beyond.