Bill > HB478

This bill establishes new regulations for health insurers regarding ambulance service reimbursement in Alabama, primarily focusing on out-of-network emergency medical service providers. The legislation requires health insurers to offer emergency medical service providers an in-network option and sets a minimum reimbursement rate of 185% of the current Medicare rate for out-of-network ambulance services. The bill prohibits insurers from requiring prior authorization for emergency services, mandates that insurers pay claims within 30 days, and prevents emergency medical service providers from balance billing patients for covered services. Additionally, the bill defines key terms such as "clean claim," "emergency medical service provider," and "health care benefit plan," and includes a requirement for the Alabama Department of Public Health to conduct a comprehensive study on the effectiveness of these reimbursement payments by January 1, 2028. The provisions are set to take effect on October 1, 2025, and will automatically be repealed on June 1, 2029, serving as a temporary measure to address ambulance service reimbursement challenges in the state.

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