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Good News about AB 716 Ground Ambulance Bill
by Craig Gussin
Great news for everyone in California who ever needs to use a ground ambulance!! Governor Newsom signed A B716 the Ground Ambulance Bill into law effective January 1, 2024.
For over 20 years the California Agents and Health Insurance Professionals (CAHIP), formerly California Association of Health Underwriters (CAHU), and I have been advocating for protecting consumers across the USA when they have to use a ground ambulance, so that they are not saddled with a huge ambulance bill, since most ambulances are not in network on most health insurance plans.
This bill will require the authority to annually report the allowable maximum rates for ground ambulance transportation services in each county, including trending the rates by county, as specified. It deletes that direct reimbursement requirement and requires a health care service plan contract or a health insurance policy issued, amended, or renewed on or after January 1, 2024, to require an enrollee or insured who receives covered services from a non-contracting ground ambulance provider to pay no more than the same cost-sharing amount that the enrollee or insured would pay for the same covered services received from a contracting ground ambulance provider.
The bill prohibits a non-contracting ground ambulance provider from sending to collections a higher amount, limits the amount an enrollee or insured owes a non contracting ground ambulance provider to no more than the in-network cost-sharing amount, and prohibits a ground ambulance provider from billing an uninsured or self-pay patient more than the established payment by Medi-Cal or Medicare fee-for-service amount, whichever is greater.
It also requires a plan or insurer to directly reimburse a non-contracting ground ambulance provider for ground ambulance services at the authorized rate, or an amount established by regulation, as specified, unless it reaches another agreement with the non-contracting ground ambulance provider.
Thank you to our members and our lobbyist for your hard work to help get this bill passed.
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