Bill > HB1061

This bill addresses "no surprise ambulance billing" in Tennessee by establishing protections for patients who receive out-of-network ambulance services during an emergency medical condition. Specifically, the bill prohibits out-of-network ambulance service providers from balance billing (charging patients for the remaining balance of a medical service not covered by their insurance) enrollees in health benefit plans for emergency ambulance services starting July 1, 2025. Patients will only be responsible for paying the lesser of three options: their plan's in-network cost-sharing amount, the ambulance service provider's billed charges, or 325% of the Medicare/Medicaid published rate for the same service in the same geographic area. Health insurers must treat these cost-sharing amounts the same as in-network services, applying them toward the patient's deductible and out-of-pocket maximum. The bill also prevents ambulance service organizations from requiring patients to sign documents that would waive these protections. Key definitions are provided for terms like "ambulance," "emergency medical condition," and "health benefit plan" to ensure clear understanding of the bill's scope and application.