Ground ambulance services; to prohibit balance billing and set minimum reimbursement rates by health care insurers to emergency medical service providers

HB 400 prohibits insurance companies from allowing ambulance providers to bill patients for the difference between the insurance payment and the provider's charge (balance billing) for covered emergency ambulance services. It sets minimum reimbursement rates: 200% of Medicare's ambulance fee schedule for in-network providers (covering transport and "treat in place" services) and 180% for out-of-network providers, effective 2026-2027. Payment at these rates is defined as "payment in full," meaning providers cannot seek additional payment from patients beyond their standard cost-sharing amounts (like deductibles). This directly affects ambulance providers (both in-network and out-of-network) and patients receiving emergency ambulance care in Alabama.