The bill SB 245-FN seeks to regulate reimbursement for ground ambulance services under the managed care law in New Hampshire, specifically prohibiting balance billing for these services. It introduces a new subdivision to RSA 420-J, defining terms such as "enrolling ground ambulance provider," "ground ambulance provider," and "nonparticipating ground ambulance provider." The legislation establishes a temporary reimbursement rate for participating and enrolling ground ambulance providers at 3.25 times the Medicare rate from January 1, 2026, to December 31, 2027, transitioning to a cost-based rate schedule starting January 1, 2028. Additionally, it mandates that health carriers may apply cost-sharing for ambulance services and that ambulance providers are responsible for collecting any associated costs. The bill also includes the deletion of specific procedure codes related to ground ambulance services from current law.

Furthermore, SB 245-FN establishes a commission to review and reform the financing and delivery system of ground ambulance services, with a report due by June 30, 2027. The commission will consist of various stakeholders, including representatives from legislative committees and health associations, and will explore the feasibility of applying for a federal waiver to create a uniform, cost-based reimbursement schedule. The bill emphasizes the importance of good faith engagement in contract negotiations and includes penalties for providers that fail to comply with data submission requirements. It also allows for the collection and allocation of fines imposed on insurers for violations of insurance regulations, with funds directed towards an independent study of ground ambulance costs. Overall, the bill aims to create a more standardized and equitable reimbursement framework while enhancing accountability among providers.

Statutes affected:
As Amended by the House: 358-T:1, 153-A:38, 400-A:15
Version adopted by both bodies: 358-T:1, 153-A:38, 400-A:15