AL SB269

Health insurers must reimburse in-network emergency medical service providers at minimum 200% of the Medicare Ambulance Fee Schedule rate for emergency ground transport (effective October 1, 2026) and treat-in-place services (effective January 1, 2027)

Out-of-network providers must receive minimum 180% of the Medicare Ambulance Fee Schedule rate for covered services, with payment due within 30 days for electronic claims or 45 days for written claims

Balance billing is prohibited—providers cannot bill enrollees beyond in-network cost-sharing amounts (deductibles, copays, coinsurance), regardless of network status

Emergency medical service providers and health insurers must submit annual financial and operational reports to the Alabama Department of Public Health beginning in 2027

The act includes a sunset provision repealing Sections 1-5 on June 1, 2029, and requires a commissioned study (capped at $50,000) on the law's impact on emergency medical services, due December 1, 2028