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Committee hears testimony on EMS reimbursement bill after emotional rural accounts
Summary
Lawmakers in committee heard hours of public comment on HB400, a bill to expand reimbursement for emergency medical services and allow treatment-in-place, with supporters citing rural ambulance shortages and opponents warning that mandates could raise insurance costs. The bill was carried over for a vote next week.
A legislative committee heard hours of testimony on HB400, a bill that would change how ambulance services are reimbursed and permit payment for care provided without transport, with proponents saying the measure would shore up rural emergency services and opponents warning it could raise insurance costs for consumers.
The bill’s sponsor described a substitute and amendments that add a university-contracted study and a sunset provision to allow evaluation. Steven Wilson, a paramedic and director of operations for a Montgomery-based EMS service, told the committee, “This bill will help with our rural healthcare crisis,” describing multiple counties that lack hospitals and occasions when no crew was available. Vicki McCroy, a paramedic from Pickens County, gave an emotional account of a rural response: she said a patient’s family “watch[ed] him take his last breath because it took us an hour and 15 minutes to get there,” arguing that treatment-in-place could prevent unnecessary long transports.
Opponents and some members pressed whether the measure effectively mandates higher payments and whether those costs would be passed to consumers. Sid Phelps, a self-employed trucking business owner, said mandates have in his experience “caused incredible increases” in insurance costs and cautioned the committee to consider alternatives. Eric Pinley, president of the Alabama Ambulance Association, countered with reimbursement data: he said Alabama currently reimburses about 140% of CMS Medicare rates, compared with 325% in some states, and described the bill’s approach — including a study and a target reimbursement of roughly 250% — as a means to address ambulance deserts and avoid workforce loss. Sunny Brassfield, speaking for a local-government insurance program, estimated the premium impact for participants would be between $500,000 and $600,000 statewide, roughly a $0.76 monthly increase per participant, and emphasized the bill’s prohibition on balance billing for covered plans.
The committee adopted the proposed substitute and amendments, then opened a public hearing. After receiving proponent and opponent testimony, the chair said the bill would be carried over and placed on next week’s agenda for a vote; there was no final committee vote at this meeting.
Why it matters: Proponents say the bill is intended to stabilize rural EMS availability by raising reimbursement and paying for non-transport care; opponents say statewide mandates can shift costs to consumers and small businesses. The committee added independent study and sunset language to allow evaluation before full, long-term adoption.
What’s next: The committee carried HB400 over for a vote next week; the study called for in the substitute is to be contracted with an accredited university and a report is expected by December 1, 2028, with the bill’s sunsets and effective dates spelled out in the adopted amendment.
