Bill > H489

This bill provides comprehensive regulations for emergency ambulance services and health insurance coverage, focusing on reimbursement rates and patient protections. The legislation establishes that insurers must cover emergency medical transportation services, even when provided by out-of-network ambulance providers, and sets specific minimum reimbursement standards. For out-of-network ambulance services, the bill mandates that insurers pay either the rate set by local government entities, or up to 400% of the Medicare rate for the same services in that geographic area. The bill also limits patient cost-sharing for emergency transportation to no more than $100 or 10% of the minimum reimbursement rate, ensures that insurers pay ambulance providers directly, and defines key terms like "emergency medical condition" and "emergency medical transportation." Importantly, the bill clarifies that payment at the specified rates is considered payment in full, though patients can still be responsible for standard copayments, coinsurance, and deductibles. The provisions will take effect on October 1, 2025, and apply to insurance contracts issued or renewed after that date, with the goal of protecting patients from unexpected high costs during medical emergencies.

Business and Industry, Government Affairs, Health and Social Services

https://www.ncleg.gov/BillLookUp/2025/H489