Health insurers; minimum reimbursement rate for ambulance services that are out-of-network established

HB 478 requires health insurers to pay out-of-network ambulance providers at a minimum of 185% of the Centers for Medicare & Medicaid Services (CMS) rate for the same service in the same area, preventing providers from charging patients the difference after insurance payment (balance billing). Insurers must pay claims within 30 days of receiving a complete claim and cannot require prior authorization for emergency ambulance services. The bill also prohibits insurers from reducing in-network rates after October 1, 2025, and mandates a two-year study by the Alabama Department of Public Health on whether the law improves ambulance response times and rural service availability. This directly affects insurers, ambulance providers, and Alabama residents covered by health insurance plans who use emergency ambulance services.