This bill aims to prohibit surprise billing for ground ambulance services and establishes specific reimbursement protocols for both participating and non-participating ambulance service providers. It mandates that health carriers provide reimbursement for ground emergency ambulance services, including those responding to 9-1-1 calls, at rates set by local governmental entities or, if no rates are established, at a minimum of 325% of the current Medicare rates based on the service's geographic area. The bill also prohibits non-participating ambulance providers from balance billing patients for any amounts beyond the required copayments, coinsurance, or deductibles. Additionally, it ensures that prior authorization is not required for emergency transport and recognizes services requested by medical professionals as medically necessary.

The bill includes several key provisions, such as requiring health carriers to clearly indicate on payment explanations whether claims are subject to the commissioner's jurisdiction and allowing carriers to negotiate contracts with non-participating providers while adhering to the reimbursement rates outlined in the bill until a contract is established. The effective date for these changes is set for January 1, 2026. The fiscal impact of the bill is expected to increase health insurance premiums due to higher reimbursement rates, with estimates suggesting a potential increase of $1.13 to $1.38 per member per month, translating to an approximate 0.5% rise in overall premiums.