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Ambulance providers said payment issues can contribute to a lack of access, but this legislation could help address part of the problem.
Lauren Chapman/IPB NewsGov. Eric Holcomb signed legislation Wednesday that establishes requirements for how health plans pay out-of-network ambulance providers. The new law also includes a grant program that would support communities starting or expanding their mobile response programs.
HEA 1385 requires health plans to pay out-of-network ambulance providers for transports at rates set by a county or municipality. If there is no local rate, insurers pay the lower of two options: the provider’s billed charges or 400 percent of the Medicare base rate.
Providers said payment issues can contribute to a lack of access, but this legislation could help address part of the problem.
The law does not affect a number of insurance plans that the state cannot regulate under federal law. It also doesn’t impact state employee health plans or Medicaid.
READ MORE: Grant program could help communities create, expand mobile crisis response programs
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The law also establishes the Community Cares Initiative Grant pilot program to provide financial support for mobile response programs.
These programs can support existing emergency services and connect people to resources within the community.
The language establishing the grant takes effect July 1. The out-of-network ambulance payments portion of the measure takes effect Jan. 1, 2025.
Abigail is our health reporter. Contact them at aruhman@wboi.org.
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