Bill > H5042

This bill aims to protect patients from unexpected costs associated with emergency ambulance services. It mandates that insurance companies (referred to as "carriers") must pay ambulance service providers directly and promptly for emergency ground ambulance services rendered to insured individuals, even if the provider is not in the insurance company's network. The payment rate will be based on rates set by the municipality where the patient was transported, provided these rates consider the provider's costs, revenue from different payers, or are established through a public process. If no municipal rate exists, the payment will be at least 325% of the Medicare rate or the provider's billed charges, whichever is less. Once an ambulance provider receives payment from the carrier, they are considered fully paid for the service and cannot bill the patient further, except for a small cost-sharing amount (up to $100) that will count towards the patient's insurance deductible and out-of-pocket maximum. The bill also limits charges for uninsured or self-pay patients to the Medicare rate and prohibits ambulance providers from using aggressive debt collection tactics like wage garnishments or liens on homes. Additionally, hospitals and nursing homes will be required to share patient insurance and demographic information with ambulance providers who treated a mutual patient.

Budget and Finance, Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H5042