The Office of the Insurance Commissioner (OIC) recently published a 39-page legislative study report providing policy recommendations for managing billing practices for ground ambulance services.

Since 2019, Washington state and the federal government have enacted laws with the goal of protecting consumers from “surprise” billing practices in specific settings where consumers have no opportunity to choose their provider. To date, none of the adopted legislation has applied to ground ambulance services in part due to the complexity of providing and funding EMS services at the local and county level.

In 2022, the legislative passed HB 1688 directing the OIC to submit a report to the legislature on applying balance billing regulations to ground ambulances. In early 2023, OIC convened an advisory group made up of public and private ground ambulance providers, insurance providers, and patient advocacy groups. The group met several times to study the issue and develop recommendations. At the beginning of October, the group published their findings and recommendations that include:

• Prohibiting balance billing of consumers for ground ambulance services;
• Reimbursing ground ambulance services at a local jurisdiction’s fixed rate or, if no local rate exists, at the lesser of a fixed percentage of Medicare or billed charges; and
• Mandating coverage for emergency transportation to alternative sites.

With these initial recommendations now published, additional work will be done on the issue between now and 2028. AWC recommends that cities who provide ground ambulance services engage with their state policy makers to ensure they are aware of the fiscal impacts balanced billing could have on locally provided ambulance services. An executive summary and the full legislative report can be viewed on OIC’s website.

AWC is grateful for the work of Eric Koreis, Battalion Chief, Longview Fire Department, and Tom Huntington, Fire Chief, Richland Fire Department, representing the views of cities on the OIC advisory group.