By Madison Harden-Stein and Jack Hoadley
While the federal No Surprises Act does much to shield consumers from surprise medical bills, the law has a significant gap: consumers can still face large, unexpected bills in medical emergencies when the ambulance that took them to the hospital was out of network. Each year, about 3 million people with private insurance rely on ground ambulance transport in emergencies — in circumstances when they typically have no ability to choose a provider. More than one of four of those privately insured ambulance trips may result in a surprise bill, leaving patients owing hundreds of dollars out of pocket. In 2021, the average ground ambulance bill for those with commercial insurance was $1,093.
In 2024, the Advisory Committee on Ground Ambulance and Patient Billing (GAPB) issued recommendations for federal reforms to address the problem. To date, federal action has stalled, but states have taken the lead in protecting consumers from ground ambulance surprise billing. In this blog post for the Commonwealth Fund, Madison Harden-Stein and Jack Hoadley explore how states are stepping into the gap left by the No Surprises Act. This year alone, five states have enacted new laws, each experimenting with different payment methodologies, service scopes, enforcement, and consumer protections. In total, people in 22 states now have some protection from surprise bills for ground ambulance services.
Read the full blog post here.