HB 469 Alabama House · 2025 Regular Session

Ground ambulance services; prohibit out-of-network providers from balance billing

HB 469 aims to protect individuals from "surprise billing" for out-of-network ground ambulance services. The bill prohibits out-of-network ground ambulance providers from charging insured individuals more than their in-network cost-sharing amount. It establishes a minimum reimbursement rate for these services, set as the lesser of the provider's billed charge or 325% of the Medicare rate, which is considered payment in full. Health insurers are required to directly pay the out-of-network ambulance service, not the insured individual, and disputes between insurers and providers are to be resolved without involving the enrollee.

Issues: ✓ Healthcare

Bill status died 1 of 4 stages cleared

Introduction

Mar 2025

Committee Review

Floor Vote

Governor

Introduced Mar 20, 2025 Last action May 6, 2025

Maddy AI version diff · 1 comparison

What changed between versions

Introduced → Insurance 1st Substitute · 5 edits

MODERATE

The bill was amended from an introduced version to an insurance substitute version, significantly expanding its scope to include reporting requirements and a sunset provision. The original version focused only on prohibiting surprise billing by setting minimum reimbursement rates, while the new version adds requirements for providers to submit annual reports to the Department of Public Health and requires the department to hire an outside consultant to study the bill's effects on access to emergency services. The new version also includes a repeal date of June 1, 2029.

Scope change

The bill's scope expanded from solely regulating reimbursement rates to include administrative reporting requirements and a sunset provision for the law itself.

REQUIREMENT

Added requirement for ground ambulance service providers to submit annual reports with financial information to the Alabama Department of Public Health.

Added requirement for the Alabama Department of Public Health to contract with an outside expert to study the bill's effects on access to ground ambulance services and provide recommendations for improvement.

Modified Section 2 to require health care insurers to contract with any willing out-of-network emergency medical service provider that accepts comparable in-network payment terms.

TIMELINE

Added a sunset provision requiring the bill to be repealed on June 1, 2029.

DEFINITION

Modified the definition of 'Health Care Insurer' to include nonprofit agricultural organizations that offer health benefits to their membership.

Floor votes

How they voted

No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Apr 9, 2025

Lower · Passed

Reported Out of Committee House of Origin

lower

Mar 20, 2025

Lower · Passed

Pending Committee Action in House of Origin (Insurance)

lower

1 primary · 0 co-sponsors