AL HB400

Health insurers must reimburse in-network ground ambulance providers at minimum 200% of the Medicare Ambulance Fee Schedule rate for emergency transport and treat-in-place services, effective October 1, 2026; out-of-network providers receive minimum 180% of Medicare rates starting January 1, 2027

Ambulance providers are prohibited from balance billing patients beyond the in-network cost-sharing amount (deductibles, copays, coinsurance), with insurers required to pay providers directly within 30-45 days depending on claim type

Health insurers must contract with any willing licensed emergency medical service provider under terms comparable to existing in-network providers

Ground ambulance services and health insurers must submit annual operational and financial reports to the Alabama Department of Public Health, which must also hire a consultant (cost capped at $50,000) to study the act's impact on emergency service access

The act takes effect October 1, 2026, and automatically repeals on June 1, 2029