Emergency services, insurers and 9‑1‑1 leaders debate ambulance reimbursement and paging methods (HB1322)

Representative Weiss’s bill on ambulance reimbursement (HB1322) drew testimony from emergency‑services, 9‑1‑1 and insurance officials about patient protections, provider solvency and communications reliability.

Bill Kalanick, for the North Dakota EMS Association, said ambulance providers face rising costs (he testified costs to deliver services rose roughly 66% over six years while reimbursement increased about 11%) and that underpayment threatens access, particularly in rural areas. He described three primary objectives: prohibit ambulance providers from collecting above a patient's plan cost‑sharing, ensure payment is sent directly to providers, and set an insurer payment rate to preserve service access.

Kalanick and others discussed proposed rates tied to a Medicare multiplier. The bill originally proposed 400% of Medicare, which Kalanick said would improve funding but still fall short of average total costs; a later amendment set 250% of Medicare. Witnesses supplied example figures: Medicare base rates and per‑mile rates were cited in testimony (one witness cited a Medicare BLS emergent base of about $435.90 and $8.76 per mile), and the speakers noted average cost‑per‑response figures the state and federal data have shown.

9‑1‑1 professionals warned about a House amendment that would allow third‑party paging applications and cell‑phone‑based notifications to serve as primary paging methods. Sarah Miller, president of the North Dakota 9‑1‑1 Association and a public‑safety telecommunications director, said public networks and third‑party services can fail unpredictably and that National Fire Protection Association guidance discourages relying on public cellular networks as a primary paging channel. Miller urged the committee to remove or limit that amendment and involve PSAPs (public safety answering points) in implementing communications rules.

Insurance regulators said they were neutral on the bill but noted drafting issues: sections that assign rulemaking to the insurance commissioner would need to be located in the insurance title of state code for the department to have rule authority. A large public employer health plan (NDPERS) may face a modest fiscal impact from higher ambulance reimbursement rates and legislators were urged to consider whether to appropriate funds.

Ending: The committee heard multiple proponents and neutral technical witnesses and asked sponsors to work with the 9‑1‑1 community and insurance department on language about communications protocols and administrative code placement before further action.