MA H1261

Requires insurance carriers to pay out-of-network ambulance providers directly at rates established by the municipality where the patient was transported, with rates based on provider costs, payer mix, or adopted through public hearings

Sets minimum reimbursement at 325% of Medicare rates (or billed charges, whichever is less) when no municipal rate exists, and caps patient cost-sharing at $100 for emergency ambulance services

Prohibits ambulance providers from balance billing insured patients beyond the $100 cost-sharing cap, and requires cost-sharing payments to count toward in-network deductibles and out-of-pocket maximums

Limits charges for uninsured or self-pay patients to Medicare rates and prohibits aggressive debt collection tactics including wage garnishment, home liens, credit reporting, or civil lawsuits for unpaid ambulance bills

Requires hospitals and nursing homes to share patient insurance and demographic information with ambulance providers upon request, and mandates municipalities report their ambulance rates annually to the Center for Health Information and Analysis