Bill > HB245

This bill establishes new requirements for health benefit plans regarding emergency ground ambulance services in Kentucky, designed to protect patients from unexpected high costs. The legislation mandates that health insurance plans must cover emergency ground ambulance services, including those provided by out-of-network providers, and prohibits these providers from balance billing patients beyond their standard cost-sharing amounts. The bill defines key terms like "emergency ground ambulance services" and "out-of-network ground ambulance provider" and sets a minimum reimbursement rate for such services, which will be either the local emergency ground ambulance service rate or up to 400% of the Medicare reimbursement rate. Insurance companies must process and reimburse claims within 30 days, paying providers directly and sending clear explanations if claims are denied or need additional information. The bill applies to all health benefit plans issued or renewed on or after January 1, 2026, and includes amendments to existing state laws to ensure consistency with these new requirements, ultimately aiming to make emergency medical transportation more affordable and transparent for Kentucky residents.

Business and Industry

https://apps.legislature.ky.gov/record/25RS/hb245.html