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Senate committee backs bill to raise ambulance pay, ban balance billing and require EMS data
Summary
SB 269 would raise ambulance reimbursement, add treat‑in‑place reimbursement, bar balance billing and require EMS data collection and an actuarial study; sponsors adopted a substitute and advanced the bill after proponents said current reimbursements average about 142% of the CMS rate and proposed changes could approach ~245% in super‑rural areas.
Senator Singleton told the committee SB 269 addresses declining ambulance service in rural areas by raising reimbursement rates, establishing reimbursement for "treat‑in‑place" care, banning balance billing, and requiring EMS reporting and an actuarial study. "This bill deal[s] with reimbursement for ambulance services," Senator Singleton said, describing calls from constituents struggling to keep local ambulance services solvent.
A representative for the Alabama Ambulance Association (presenter identified as Ryan) told senators Alabama currently reimburses about 142% of the Centers for Medicare & Medicaid Services (CMS) ambulance fee schedule and that the bill would create a reimbursement floor and a super‑rural add‑on that in example zip code 35462 would yield roughly 245% of CMS in some localities. "In Alabama, we're currently... reimbursed approximately 142% of the CMS rate," Ryan said. He also explained that banning balance billing would prevent providers from sending patients supplemental bills when insurance covers only part of a transport.
The bill requires EMS data to be submitted to the Alabama Department of Public Health; the Alabama Ambulance Association would contract with Troy University to run an actuarial study on rates, due to the legislature in December 2028. The measure also includes a sunset provision in June 2029 if stakeholders cannot agree on long‑term rates.
Senator Smith urged swift action, calling it "unconscionable" to debate the cost of saving lives and moved for a favorable report on the substitute; the committee adopted the substitute and advanced the bill. Committee debate clarified that the substitute text uses a 200% baseline with a super‑rural add‑on that produces the higher illustrative percentages in some zip codes.
Ending: After adopting the substitute and a committee vote, the committee gave SB 269 a favorable report and advanced it to the Senate floor; next steps include data collection, the contracted actuarial study and continued stakeholder negotiations ahead of the 2029 sunset and December 2028 report date.
