Bill > SB52

This bill prohibits "balance billing" by out-of-network ground ambulance providers in the state of Alabama. It defines key terms such as "emergency ground transport," "health insurance plan," and "out-of-network," and sets out the following provisions: (1) Out-of-network providers cannot collect from enrollees more than the in-network cost-sharing amount, (2) Insurers must certify the in-network cost-sharing amount to out-of-network providers upon request, (3) Out-of-network providers can be paid the median in-network amount for the relevant geographic area, and (4) Disputes between insurers and providers can be resolved through the insurer's internal dispute resolution process or a mutually agreed-upon contractor, without involving the enrollee. The bill also requires the state insurance department to gather and provide data on median in-network amounts to facilitate these payments. The bill is set to take effect on January 1, 2025.

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