Bill > H1261

This bill aims to protect patients from unexpected high costs associated with emergency ambulance services by establishing several key protections. The legislation requires insurance carriers to directly pay ambulance service providers for emergency services at rates established by the local municipality, with specific guidelines about how those rates should be determined. If no municipal rate exists, reimbursement will be set at 325% of Medicare's published rate for the same service in that geographic area. The bill limits what uninsured patients can be charged for emergency ambulance services to the Medicare rate and prohibits aggressive debt collection practices like wage garnishments or liens against uninsured patients. Additionally, the bill mandates that hospitals and nursing homes share patient insurance information with ambulance providers upon request. For insured patients, the legislation ensures that any cost-sharing payments will be credited toward their in-network deductible, and ambulance providers cannot bill patients beyond their carrier's cost-sharing requirement (capped at $100). The bill specifically excludes certain contracts, such as those with the Group Insurance Commission and MassHealth, from these provisions, and it maintains that the law does not create coverage where none previously existed in a patient's insurance policy.

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https://malegislature.gov/Bills/194/H1261