Healthcare (Medicare)

This bill is a resolution that formally thanks the Alabama Congressional Delegation for their efforts to address long-standing issues facing the state's hospitals. It highlights the significant economic role of healthcare facilities in Alabama while noting challenges such as high rates of uninsured patients and recent rural hospital closures. The text encourages the Centers for Medicare and Medicaid Services to adjust the Medicare wage index formula to better reflect labor commuting patterns in rural areas. Ultimately, the measure expresses gratitude for legislative advocacy rather than creating new laws or changing specific policies.

SB 269 regulates how health insurers pay for ground ambulance services in Alabama. It prohibits surprise billing by requiring insurers to pay providers a set minimum rate (200% of Medicare’s ambulance rate for in-network services, 180% for out-of-network) as full payment, meaning patients can only be charged their standard in-network copay or deductible. Ambulance providers and insurers must report financial data to the Alabama Department of Public Health, and an independent expert will study the law’s impact on access to ambulance services. The law expires on June 1, 2029. It directly affects emergency medical service providers and patients covered by health insurance plans.

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.

HB 300 requires all health insurance plans sold in Alabama that cover breast exams to provide screening and diagnostic mammograms without charging deductibles, copays, or coinsurance. It directly affects Alabama residents with health insurance, ensuring no out-of-pocket costs for medically necessary breast screenings under the National Comprehensive Cancer Network Guidelines. The bill covers both routine screening exams (for high-risk individuals) and diagnostic exams (to evaluate abnormalities), but excludes limited policies like dental-only or Medicare supplements. The law takes effect January 1, 2027.

SB 81 would require dental insurance companies in Alabama to spend at least 75% of premiums collected on individual dental care claims and 83% on group plans. Insurers failing to meet these thresholds must refund the difference to policyholders. The bill also mandates that insurers publicly report their financial data, including claims payments and expenses, to the Insurance Commissioner. This applies to standalone dental plans sold by commercial insurers, excluding self-funded plans, Medicare Advantage, and certain state-run programs.