Lifetime Citizen Portal Access — AI Briefings, Alerts & Unlimited Follows
Subcommittee splits on ambulance billing: keeps higher-rate bill alive, advances lower-rate option
Loading...
Summary
After extensive testimony from EMS chiefs, fire officials and insurers, the subcommittee voted to retain the higher-reimbursement proposal (HB725) for further work and to advance a lower-rate bill (HB316) in subcommittee; both measures would limit balance billing but differ on insurer reimbursement levels.
New Hampshire lawmakers spent a lengthy portion of the Commerce and Consumer Affairs subcommittee meeting debating how to limit ambulance balance-billing and how much private insurers should reimburse ambulance providers.
Two competing approaches: The subcommittee considered two bills. House Bill 316 would limit balance billing and set a reimbursement level tied to a percentage of Medicare rates chosen by the bill—s analyst; supporters described it as a data-driven, actuarial approach. House Bill 725 would also remove balance billing but set a higher statutory reimbursement level intended by ambulance providers to cover operational costs.
Testimony and concerns: Fire chiefs and ambulance providers, including Michael Setar of the Tilton-Northfield Fire District, gave operational testimony saying current Medicaid and Medicare reimbursements leave large shortfalls that local taxpayers often supplement. "My operating budget—s majority is EMS," Setar said, explaining local budget impacts and the prevalence of EMS calls. Providers and municipal officials urged higher reimbursements to keep services viable. Supporters of a higher payment level argued that a modest per-person premium increase spread across insured residents would preserve ambulance capacity.
Insurers and some committee members urged caution. Analysts who prepared a cost study described methodology choices and exclusions; some members said the actuarial presentation lacked the kind of narrative explanation they wanted. Insurers said the fiscal impact could be significant and recommended a measured path tied to verified claim data.
Committee actions: After debate, the subcommittee voted to retain HB725 (the higher-rate option) for more work and to report HB316 "ought to pass" in subcommittee. The clerk recorded the votes as follows in subcommittee proceedings: HB725 retained by a 7-0 tally; HB316 was reported "ought to pass" by a 5-2 tally.
Why it matters: Ambulance providers say they face a structural funding gap because Medicaid and Medicare reimbursements are low and local governments already subsidize services. The debate centers on whether private insurers should shoulder more of that gap via higher premiums or whether incremental, actuarially timed increases tied to validated data are preferable. The two bills represent different policy choices about who bears the cost when public payers underpay emergency transport.
Next steps: HB725 will be held for further study and potential amendment; HB316 will move forward from subcommittee. Members asked the department and actuaries for additional breakdowns of claim code impacts and said they would revisit the issue in September to evaluate outcomes and potential compromises.
