Bill > SB51

This bill establishes regulations for reimbursement of ambulance services by health insurers in Alabama, setting clear guidelines for both in-network and out-of-network emergency medical service providers. The bill defines key terms like "clean claim," "health care insurer," and "emergency medical service provider," and specifies that for in-network providers, the minimum reimbursement will be the greater of the contracted amount or 200% of the Medicare rate as of January 1, 2025, while out-of-network providers will be reimbursed at the lesser of their billed charge or 180% of the Medicare rate. The legislation prohibits emergency medical service providers from billing patients beyond the minimum reimbursement amount, except for their in-network cost-sharing amount, and requires health insurers to pay claims within 30-45 days depending on the claim type. Additionally, the bill mandates that emergency medical service providers submit annual reports to the Alabama Department of Public Health detailing their services and finances, and requires a study to be conducted by a healthcare consultant to assess the impact of these new reimbursement rules, with a report to be submitted to legislative leaders by December 1, 2028. The provisions of the bill will take effect on January 1, 2026, and are set to be repealed on June 1, 2029, allowing for a comprehensive evaluation of their effectiveness.

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