NH Commerce and Consumer Affairs subcommittee votes to ITL HB 185 after debate over ambulance reimbursement

The Commerce and Consumer Affairs subcommittee voted unanimously to recommend Inexpedient to Legislate (ITL) on House Bill 185 after an extended discussion about how health insurers should reimburse ambulance providers and whether to ban balance billing.

The vote came after members and stakeholders described three different proposals for addressing ambulance reimbursement. Sponsors and witnesses contrasted HB 185, which a sponsor described as requiring insurers to pay the ambulance company’s billed amount; a proposal that would require insurers to reimburse at 325% of Medicare rates and bar balance billing; and HB 316, which would direct the Insurance Department to use a consultant and published cost data to calculate a default reimbursement schedule (PCG’s analysis produced a recommended level the department described as roughly 204% of Medicare for the current analysis).

Why it matters: ambulance reimbursement affects municipal budgets, provider finances and patient exposure to “balance bills.” Subcommittee members repeatedly framed the choice as shifting costs between property taxpayers, insurers (and thus premiums) and patients. Several municipal and provider witnesses said existing in‑network contracts are rare outside urban areas; some providers said network payments are too low to sustain operations.

Members and witnesses

M…