‘Surprise’ ambulance billing legislation signed

(The Center Square) – New Hampshire Gov. Kelly Ayotte signed a bill Thursday that bans “surprise billing” for ambulance services and sets new reimbursement rates for emergency medical service providers and fire departments.

The legislation bans the practice of billing patients for the price of an ambulance ride when it exceeds what an insurance company is willing to pay. Beginning next year, ambulance providers will be reimbursed by insurers at 325% of the federal Medicare rate. After two years, regulators will conduct an actuarial study to decide if the rate should change based on inflation and other factors.

“No one should have to face unknown costs when experiencing a medical emergency,” Ayotte, a first-term Republican, said in a statement. “In addition to prohibiting surprise billing to protect patients, we’re ensuring our EMS providers and fire departments receive fair reimbursement for their vital services.”

Mike Sitar, chief of the Tilton-Northfield Fire and EMS Department, was among those who praised Ayotte and lawmakers for approving the legislation. He said the move “not only protects the public from devastating unforeseen costs but helps guarantee that firefighters and emergency medical personnel have the means to keep providing life-saving care across the state.”

“For far too long, local fire departments have struggled with payment rates that don’t accurately represent the cost of preparedness and response,” he said in a statement.

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A report released earlier this year by the Insurance Department and Public Consulting Group LLC, a consulting firm hired by the state, found that surprise charges for ground ambulance services are costing Granite Staters an average of $3,570 in out of pocket costs.

“These high costs disproportionately affect financially vulnerable households, many of which struggle to cover regular expenses,” the report’s authors wrote.

The report recommended providers charge a base rate of 202% of the federal Medicare rate for ambulance service, and 209% of the Medicare rate per mile the ambulance travels. That rate should be updated after two years, they said.

“It is important to conduct regular rate reviews to ensure rate fidelity as well as to ensure that rates present an accurate picture of the cost of delivering ground ambulance services in the state,” they wrote in the report.

“This new law takes the uncertainty out of ambulance bills for consumers and providers in a fair way,” said Chris Stawasz, Northeast Regional Director of Government Affairs for American Medical Response. “New Hampshire EMS providers can now focus on what they do best – providing pre-hospital healthcare – knowing there will be reimbursement predictability and hopefully additional financial stability.”

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