This bill aims to prohibit surprise billing practices for ground ambulance services and establishes specific reimbursement guidelines for both participating and non-participating ambulance service providers. It introduces a new section, RSA 420-J:8-i, which mandates that health carriers reimburse non-participating ground emergency ambulance service providers either at rates set by local governmental entities or, in the absence of such rates, at a minimum of 325% of the current Medicare rates based on the service's geographic area. The bill also prohibits non-participating providers from balance billing covered individuals for any amounts beyond their required copayments, coinsurance, or deductibles. Additionally, health carriers cannot require prior authorization for emergency ambulance transports and must indicate on payment explanations whether claims are subject to the commissioner's jurisdiction.

The bill also includes provisions that allow health carriers to negotiate contracts with non-participating ambulance providers for reimbursement rates, but until such contracts are established, the specified reimbursement rates must be followed. The act is set to take effect on January 1, 2026. The fiscal impact of the bill is expected to increase health insurance premiums due to the higher reimbursement rates mandated, which could lead to increased revenue from insurance premium taxes. The bill deletes specific procedure codes related to ambulance services from current law, indicating a shift in how these services will be billed and reimbursed moving forward.