Compare Bills

Primary Sponsor

Last Action

Ref To Com On Rules and Operations of the Senate2025-05-07

Vote Breakdown

Plain Language Summary

This bill requires health insurance plans in North Carolina to reimburse out-of-network ambulance services at a minimum rate of 100% of the local government rate (or 400% of Medicare rates if no local rate exists), and caps the patient's cost-sharing for emergency ambulance services at the lesser of $100 or 10% of the reimbursement amount.

Arguments in Favor

• •Supporters argue this bill protects patients from unexpected large bills when they use out-of-network ambulances during emergencies, since patients cannot choose which ambulance provider responds.
• •The bill ensures ambulance services are fairly compensated, which supporters contend helps maintain adequate emergency medical services in rural and underserved areas, and prevents insurers from underpaying providers.

Arguments Against

• •Opponents may argue the bill increases insurance costs by requiring higher reimbursement rates, which could lead to higher premiums for all policyholders.
• •Some insurers contend that 400% of Medicare rates is excessive and that market competition and negotiation should determine reimbursement rates rather than government mandates.
• •There may also be concerns about whether the bill's protections could incentivize unnecessary ambulance use or reduce cost controls in the healthcare system.