GA HB961

Amends Georgia's Surprise Billing Consumer Protection Act to require healthcare plans to cover out-of-network emergency ambulance transportation when requested by a first responder, healthcare practitioner, or when transport is a medical necessity.

Establishes minimum reimbursement rates for out-of-network ambulance providers: either the rate set by local government contract/ordinance, or 300% of the Medicare reimbursement rate when no local agreement exists.

Limits patient cost-sharing for out-of-network ambulance services so that copayments, coinsurance, or deductibles cannot exceed amounts charged for in-network ambulance providers.

Requires insurers to pay ambulance providers directly within 30 days of receiving a clean claim, releasing patients from further payment responsibility beyond their standard cost-sharing amounts.

Excludes air ambulance services from these provisions; applies only to ground ambulance providers licensed by the Department of Public Health.