In a significant move towards healthcare reform, a federal committee has proposed a cap on ambulance ride charges, limiting patient costs to a maximum of $100. This initiative aims to address the prevalent issue of surprise billing, where patients, even those with insurance, are often faced with exorbitant out-of-network charges for ambulance services.
Annually, over 3 million Americans are transported to hospitals by ambulances, with many facing unexpected high costs. In Texas, for example, the risk of receiving an out-of-network bill for an ambulance ride is as high as 70%. This financial burden is highlighted by a case in Austin, where a family was charged $1,082 out-of-pocket for a five-mile ambulance trip, as the local EMS provider does not contract with private insurers.
The committee’s recommendation, if enacted, would significantly alleviate this financial strain on patients. This proposal complements the No Surprises Act of 2020, which sought to eliminate surprise medical billing but did not fully address ambulance charges.
By capping ambulance fees and facilitating agreements between insurance companies and ambulance providers, the proposal not only offers financial relief but also ensures that decisions about emergency care are based on health needs rather than cost concerns. This groundbreaking recommendation, celebrated as a major victory for consumer protection, awaits Congressional approval to become law.
The federal committee, over the past six months, has been actively working to develop a payment system that would ease the billing disputes between insurance companies and ambulance providers. Their recommendation includes a novel approach where patients would be charged the lesser of $100 or 10% of the insurance company’s payment for the ambulance ride, with the insurer covering the remaining cost.
This strategy is expected to foster rate agreements between ambulance providers and insurers, leading to more predictable rates for both parties. The article was reported by Brian New, a distinguished member of the CBS 11 News team since 2013 and a recipient of ten Emmy awards, including the Lone Star Emmy for Best Investigative Reporter in 2017.
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