The bill, SB 245-FN, aims to regulate reimbursement for ground ambulance services under managed care law and prohibits 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 bill sets 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 determined by the commissioner starting January 1, 2028. It also mandates that health carriers may apply cost-sharing for ambulance services and outlines the responsibilities of ambulance providers in collecting these costs.

Additionally, the bill establishes a commission to enhance the financing and delivery system of ground ambulance services and allows the use of funds from the insurance department administration fund for an accounting and actuarial study of ground ambulance costs in New Hampshire. It requires the commissioner to publish a standardized ground ambulance provider contract template by December 31, 2025, and maintain a registry of enrolling ground ambulance providers. The bill also mandates that ground ambulance providers submit cost reports to an independent expert for validation, with non-compliance resulting in loss of access to the temporary rate schedule. Furthermore, it repeals existing statutes related to reimbursement rates and contract negotiations, while introducing new definitions and prohibiting balance billing, ensuring that covered individuals are not charged beyond what is reimbursed by health carriers.

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
CHAPTERED FINAL VERSION: 358-T:1, 153-A:38, 400-A:15