summary
Introduced
02/05/2025
02/05/2025
In Committee
05/15/2025
05/15/2025
Crossed Over
04/11/2025
04/11/2025
Passed
08/15/2025
08/15/2025
Dead
Signed/Enacted/Adopted
08/15/2025
08/15/2025
Introduced Session
104th General Assembly
Bill Summary
Makes changes to defined terms in provisions concerning billing for emergency services. Removes provision that made emergency billing provisions inapplicable to ground ambulance services. Sets forth provisions concerning coverage for ground ambulance services provided by nonparticipating ground ambulance service providers. Provides that, beginning on October 1, 2026, and each October 1 thereafter, each nonparticipating ground ambulance service provider shall file annually with the Department of Public Health, in the form and manner prescribed by the Department, its average gross charge rates and any other information required by the Department, by rule, for each of the specified ground ambulance charge descriptions. Requires the Department to publish the submitted rate information by January 1, 2027 and every January 1 thereafter. Permits the Department to request other information, as provided. Requires the Department of Insurance to direct the health insurance issuer to the location in which the information reported to the Department of Public Health is stored. Provides that a home rule unit may not regulate payments for ground ambulance service in a manner inconsistent with the specified provisions concerning billing for emergency services. Makes conforming changes. Effective immediately.
AI Summary
This bill amends the Illinois Insurance Code to introduce comprehensive regulations for ground ambulance services and emergency billing. The bill provides new definitions for terms like "emergency ground ambulance service," "ground ambulance service," and "nonparticipating ground ambulance service provider," and establishes detailed requirements for how health insurance issuers must handle billing and coverage for ground ambulance services. Starting January 1, 2027, group and individual health insurance policies must provide coverage for emergency and urgent ground ambulance services, ensuring that patients do not incur higher out-of-pocket costs when using nonparticipating providers. The bill requires nonparticipating ground ambulance service providers to file their average gross charge rates annually with the Department of Public Health, which will then publish this information. Additionally, the bill sets specific payment calculation methods for nonparticipating ground ambulance services, including using local government rates or a percentage of billed charges, and prohibits home rule units from regulating ground ambulance service payments in a manner inconsistent with the new provisions. The legislation aims to protect patients from unexpected high medical bills and increase transparency in ambulance service pricing.
Committee Categories
Budget and Finance, Business and Industry, Government Affairs
Sponsors (13)
Marty Moylan (D)*,
Ram Villivalam (D)*,
Margaret Croke (D),
Anthony DeLuca (D),
Mary Gill (D),
Jay Hoffman (D),
Linda Holmes (D),
Hoan Huynh (D),
Michael Kelly (D),
Natalie Manley (D),
Joyce Mason (D),
Rick Ryan (D),
Dave Vella (D),
Last Action
Public Act . . . . . . . . . 104-0248 (on 08/15/2025)
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