Summary of Alabama House Bill 400

HB400 regulates health insurance reimbursement, bans surprise billing, and establishes minimum payments for ambulance services, with an emphasis on rural providers.

Key Provisions:

• Health insurers must pay in-network emergency ambulance providers at least 200% of the Medicare Ambulance Fee Schedule starting October 1, 2026. "Treat in place" services are reimbursed at 200% of the Medicare basic life support rate.

  
  

• Prohibition on Surprise/Balance Billing: The required reimbursement rate serves as payment in full. Ambulance providers cannot bill insured patients beyond in-network cost-sharing amounts, deductibles, copay, protecting patients from unexpected out-of-pocket charges.

  
  

• Out-of-Network Limits: Providers are restricted from charging individuals more than specified percentages of in-network or out-of-network costs in certain scenarios.

  
  

• Reporting Requirements: Both ambulance providers and health insurers must submit operational and financial reports to the Alabama Department of Public Health.

  
  

• Study and Review: ADPH must contract with a consultant to evaluate the impact of the act and provide recommendations for improving access to emergency medical transport.

  
  

• Sunset Clause: The act's core provisions (Sections 1–5) are set to repeal on June 1, 2029.

  
  

• This bill aims to stabilize ambulance services by ensuring fair insurer payments, reducing financial strain on providers, and shielding patients from surprise bills, common issues in emergency care.