![]() Health plans will be required to pay ambulance operators the rates set by county authorities, which the study said would increase the average amount insurers pay per ride by around $2,000. Under California’s new law, patients can expect to save an average of nearly $1,100 per emergency ambulance ride and over $800 per nonemergency ride in the first year, according to a legislative analysis conducted this year. The committee plans to formally report its recommendations to Congress early next year for potential legislation.īusiness Column: How the hospital lobby derailed legislation to protect you from surprise hospital billsĬalifornia hospitals killed a measure aimed at protecting patients from surprise hospital bills ![]() The advisory committee working on a federal fix agreed last week on nonbinding proposals that would, among other things, prohibit balance billing for the vast majority of ambulance rides and cap patients’ financial liability at $100. The new law does not cover the nearly 6 million Californians enrolled in the subset of employer-sponsored health plans that are federally regulated. With the new law, she added, “they will have peace of mind.”Įxisting laws already protect Medicare and Medi-Cal beneficiaries from surprise ground ambulance bills. Under current law, people in distress sometimes decline to call an ambulance for fear of a huge bill, putting themselves or a loved one at risk, said Katie Van Deynze, policy and legislative advocate for Health Access California, which sponsored the legislation. (Medi-Cal is California’s Medicaid program, providing coverage to people with low income or disabilities.) And it prohibits ambulance operators and debt collectors from reporting patients to a credit rating agency or taking legal action against them for at least 12 months after the initial bill. The law also caps bills for uninsured people, stipulating they can’t be charged more than the Medi-Cal or Medicare rate, whichever is greater. The new law, which applies to about 14 million Californians enrolled in state-regulated commercial health plans, limits how much a non-network ambulance operator can charge patients to the amount they would pay for an in-network ambulance. ![]() The average surprise bill for a ground ambulance ride in California is $1,209, the highest in the nation, according to a December study. In California, nearly three-quarters of emergency ground ambulance rides result in out-of-network bills. She learned that the ambulance company was not in the health plan’s network and was permitted to bill patients for any uncovered portion of its charges - a practice known as balance billing. “When we received the bill, I thought our insurance company was processing the claim incorrectly,” said Jennifer Reisz, an attorney who would spend hours on the phone with the health plan, the ambulance company and a few consumer advocates. While Megan was still recovering at home from her injuries, she received a $2,400 bill from the ambulance company - after the family’s health plan had paid nearly $2,200. But the severity of Megan’s injuries - four broken ribs and a partly collapsed lung - prompted doctors to transport her 12 miles by ambulance to the Level 1 trauma center at Community Regional Medical Center in Fresno. She was taken to a hospital in Clovis, a city in Fresno County, near where the Reisz family lives. Though she was alone, her Apple Watch detected her distress and called 911. Megan fell to the ground, unable to move or speak. ![]() Last year, Jennifer Reisz’s college-age daughter, Megan, was kicked in the chest multiple times by the family’s horse.
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