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House approves HB400 (amended) to raise ambulance reimbursement and fund rural "treat-in-place" pilot

Alabama House of Representatives · February 11, 2026
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Summary

HB400 passed as amended after debate and an adopted amendment. The bill sets minimum ambulance reimbursement rates (in-network 200% of the Medicare ambulance fee schedule; out-of-network 180%), authorizes "treat-in-place" billing (basic life support rates for non-transport care), requires annual EMS data submission to the Alabama Department of Public Health and an actuarial study (capped at $50,000), and sunsets June 1, 2029.

The Alabama House advanced HB400 on a voice vote after debating reimbursement levels for ambulance services, a new "treat-in-place" payment option for low-acuity calls and fiscal impacts on insurers and consumers.

Representative Oliver, who presented the bill, said the measure is designed to shore up rural emergency medical services after years of strain. "In-network, the minimum reimbursement rate shall be 200% of the Medicare ambulance fee schedule as published by CMS rate in effect on October 1, 2026," he said. He added that the out-of-network minimum would be 180% of that same Medicare ambulance fee schedule and described a super-rural add-on based…

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