HB478 Summary

• Requires health insurers to offer in-network contracts with emergency medical service providers and prohibits in-network rates from decreasing after October 1, 2025.

• Establishes minimum reimbursement rate of 185 percent of the Centers for Medicare and Medicaid Services published rate for out-of-network ambulance services.

• Prohibits balance billing of enrollees for out-of-network emergency ambulance services and limits enrollee cost-sharing to in-network amounts.

• Mandates health insurers reimburse ambulance providers within 30 days of receiving a clean claim and prohibits requiring prior authorization for emergency medical services.

• Requires the Alabama Department of Public Health to study the impact on ambulance service responsiveness and availability, especially in rural areas, with results due by January 1, 2028; act repeals on June 1, 2029.