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Ambulance bills become subject of surprise billing sequel

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From Axios:


Driving the news:


A committee of ambulance providers, patient advocates, insurance experts, and other advisers is recommending Congress adopt a tiered payment system for reimbursing out-of-network ambulance rides.

  • Under the proposed policy, insurers would pay ambulance providers either an amount set in state law, if one exists, or locally set ambulance rates.

  • If local rates also don't exist, insurers would pay a congressionally-determined rate that's higher than Medicare reimbursement.

  • Advisers also suggested a $100 cap on patient costs for out-of-network ambulance rides. This could keep insurers from passing costs along to patients if local governments set high rates for ambulance rides, Kelmar said.

  • The advisory committee's report was released publicly at the end of August, though the committee adopted the recommendations earlier this year.

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