Bill > HB0301

This bill establishes comprehensive regulations for ground ambulance provider reimbursement and billing practices in Utah. The legislation defines key terms like "base rate" (the standard charge for transporting a patient, supplies, procedures, and medication administration) and "medication maximum cost" (the lower of national drug acquisition costs or Utah Medicaid's maximum allowable cost). The bill requires health benefit plans and workers' compensation insurance carriers to accept and directly pay ground ambulance providers for specific charges, including a standardized base rate for different levels of medical transport ($1,234.92 for EMT, $1,630.31 for advanced EMT, and $2,383.73 for paramedic transport). The bill prohibits ambulance providers from "balance billing" (charging patients the difference between billed charges and insurance payments) and sets maximum rates for mileage and medication charges. Additionally, the legislation includes provisions for specific scenarios where a higher rate can be charged, such as when a paramedic is dispatched and provides advanced life support. The bill includes a sunset provision, with these ambulance reimbursement sections set to be repealed on July 1, 2027, and it is scheduled to take effect on May 7, 2025. Furthermore, the bill mandates that the Office of the Legislative Auditor General conduct an audit of ground ambulance providers, paramedic providers, and insurance companies to review rates and payments.

Business and Industry, Health and Social Services

https://le.utah.gov/~2025/bills/static/HB0301.html