The bill, SB 245-FN, seeks 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" and "nonparticipating ground ambulance provider." The bill establishes a reimbursement rate schedule, mandating that from January 1, 2026, to December 31, 2027, participating and enrolling ground ambulance providers will receive a temporary reimbursement rate of 3.25 times the Medicare rate. Starting January 1, 2028, reimbursement will shift to a cost-based rate schedule determined by the commissioner, with annual inflation adjustments. Additionally, the bill creates a commission to enhance the financing and delivery of ground ambulance services and allows the use of funds from the insurance department administration fund for a cost study.

The legislation also includes provisions for the submission and auditing of cost reports by ground ambulance providers, requiring validation by an independent expert. Noncompliance will result in providers losing access to the temporary rate schedule. The bill repeals existing statutes related to temporary reimbursement rates and contract negotiations, while introducing new definitions and prohibiting balance billing to protect covered individuals from additional charges. It establishes a commission to explore an all-payer model for standardizing reimbursement across various payers and outlines public policy options for improving the ground ambulance system. The effective dates for various sections are staggered, with some provisions taking effect as early as January 1, 2026, and others by July 1, 2027, ensuring a gradual implementation of the new legal framework.

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