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Department outlines two‑year compromise to ban ambulance balance billing, set temporary rates and launch deeper cost study
Summary
The Department of Insurance presented a negotiated compromise to prohibit ambulance balance billing and adopt temporary in‑network and out‑of‑network rates while a second, more detailed cost study is completed. The amendment will be drafted and returned to the subcommittee next week; no formal vote was taken.
The subcommittee heard a compromise plan from Department of Insurance staff intended to end surprise ambulance balance bills while stabilizing emergency medical services (EMS) providers.
Under the outline presented, balance billing would be prohibited. A temporary two‑year rate structure would apply while the department conducts an expanded cost study and prepares rulemaking for a permanent rate: an in‑network payment set at 325% of Medicare and an out‑of‑network benchmark at 100% of Medicare. To encourage providers to contract with carriers, the draft would include an “any willing ambulance provider” provision and a standardized provider contract for use in negotiations.
Department staff said the in‑network rate would be available once providers file required…
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