SD SB211

Out-of-network ambulance providers are prohibited from balance billing patients for emergency medical services beyond the patient's required coinsurance, copayment, or deductible amounts.

Health benefit plans must reimburse out-of-network ambulance providers at the rate established by the political subdivision where the transport originated, or if no local rate exists, the lesser of the provider's billed charge or 275% of the Medicare allowable rate.

Reimbursement for out-of-network emergency ambulance services must be paid directly to the ambulance provider unless otherwise agreed in writing.

Ambulance providers and health plans must provide patients with a clear explanation of benefits and statement of amounts owed.

The bill exempts self-funded employer health plans, Medicaid, Medicare, and other federally regulated programs from these requirements.