This bill aims to protect individuals from balance billing for ground ambulance services by prohibiting health carriers and providers from charging patients additional fees beyond their insurance copayments, coinsurance, and deductibles. It establishes a new section in the Managed Care Law, specifically RSA 420-J:8-i, which mandates that health carriers reimburse non-participating ground emergency ambulance service providers at rates set by local governmental entities or at a minimum of 325 percent of the current Medicare rates, depending on the jurisdiction. The bill also stipulates that insurers cannot require prior authorization for emergency ambulance services and must reimburse claims within 30 days, with penalties for late payments.

Additionally, the bill clarifies that non-participating ambulance service providers cannot bill patients for amounts exceeding their insurance cost-sharing obligations, up to $100. It includes provisions for insurers to communicate clearly about claims and allows for the negotiation of reimbursement rates with non-participating providers, provided that the initial reimbursement follows the outlined rates until a contract is established. The bill explicitly excludes air ambulance services from its provisions and is set to take effect on January 1, 2026.

Statutes affected:
Introduced: 149-M:17