NC H489

Establishes minimum reimbursement rates for out-of-network emergency ambulance services at 100% of the rate set by local government entities, or if no local rate exists, the lesser of 400% of Medicare rates or the provider's billed charges

Requires insurers to pay emergency ambulance providers directly rather than sending reimbursement payments to covered persons

Caps patient cost-sharing for emergency ambulance transportation at the lesser of $100 or 10% of the minimum allowable reimbursement rate

Expands coverage triggers for out-of-network emergency services to include situations where patients had no choice in ground ambulance provider due to the emergency

Effective October 1, 2025, applying to insurance contracts issued, renewed, or amended on or after that date