House Bill 400 Alabama 2026 Session

Summary

Primary Sponsor

Ed OliverRepresentative

Republican

Session

2026 Regular Session

Title

Ground ambulance services; to prohibit balance billing and set minimum reimbursement rates by health care insurers to emergency medical service providers

Summary

HB400 would ban balance billing for emergency ground ambulance services in Alabama, require minimum insurer payments to EMS providers, mandate reporting and study effects, with a sunset repeal in 2029.

What This Bill Does

Requires health insurers to contract with any willing emergency medical service (EMS) provider to deliver covered ambulance services in-network under terms comparable to other in-network providers. Sets minimum reimbursement rates: in-network emergency ground transport at 200% of the CMS Medicare Ambulance Fee Schedule; in-network treat-in-place at 200% of the CMS basic life support rate (as published by CMS and in effect on 1/1/2027); out-of-network for covered services at 180% of the CMS rate, with the baseline rate tied to the zip code 35462. Prohibits balance billing by EMS providers or their agents; enrollees would only pay their in-network cost-sharing amounts, while insurers pay the remainder directly to providers; certifies the enrollee’s cost-sharing to out-of-network providers upon request. Imposes reporting requirements for EMS providers and health insurers to the Alabama Department of Public Health, directs an outside expert study on the act’s impact with findings and recommendations, funds the study by the three largest insurers, and repeals the act on June 1, 2029. Creates dispute-resolution options for payment disputes and directs the Department of Public Health to adopt implementing rules.

Who It Affects

• Enrollees/patients who use emergency ground ambulance services, who would not face balance billing and would pay only in-network cost-sharing amounts.
• Ground ambulance providers and health insurers, who would face new minimum reimbursement requirements, network contracting duties, mandatory reporting, and dispute-resolution processes.

Key Provisions

• Balance billing ban: providers may not bill or collect from enrollees beyond in-network cost-sharing; payment for covered services must be accepted as payment in full.
• Minimum reimbursement rates: in-network transport 200% of CMS rate; treat-in-place 200% of CMS basic life support rate (as of 1/1/2027); out-of-network 180% of CMS rate; rates apply statewide and use the CMS rate baseline for zip code 35462.
• Network contracting: health insurers must contract with any willing EMS provider to deliver covered services in-network; in-network providers must meet licensure requirements.
• Reporting and oversight: EMS providers and insurers must file detailed operational and financial reports with the Alabama Department of Public Health; DP Health must hire an outside consultant to study impacts and provide recommendations; a sunset repeal is set for June 1, 2029.
• Dispute resolution: disputes over payment can be settled through an insurer/provider internal forum or a mutually agreed independent contractor.
• Administrative rules and data: DP Health may adopt rules for reporting formats and periods; confidentiality protections apply to financial data.

AI-generated summary using openai/gpt-5-nano on Feb 12, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Insurance