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 in RSA 420-J, defining terms such as "enrolling ground ambulance provider," "ground ambulance provider," and "nonparticipating ground ambulance provider." The bill mandates that from January 1, 2026, to December 31, 2027, participating and enrolling ground ambulance providers will be reimbursed at a temporary rate of 3.25 times the Medicare rate, transitioning to a cost-based rate schedule established by the commissioner starting January 1, 2028. Additionally, it creates a commission to enhance the financing and delivery system of ground ambulance services, allowing for the use of funds from the insurance department administration fund for an accounting and actuarial study of ground ambulance costs in New Hampshire.

Furthermore, the bill establishes new regulations for ground ambulance providers, including the submission and auditing of cost reports to ensure compliance with reimbursement rates. An independent accounting expert will validate the cost data, and noncompliance will result in loss of access to the temporary rate schedule. The bill also prohibits balance billing for ground ambulance services, ensuring that covered individuals are not charged beyond their cost-sharing requirements. It includes provisions for the commission to explore a federal waiver for an all-payer model for ground ambulance services and mandates annual reporting on progress. The bill repeals certain existing statutes related to reimbursement rates and contract negotiations, aiming to create a standardized and equitable reimbursement system for ground ambulance services across the state.

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