Tackling surprise ambulance bills in Colorado

Most insured people know the best way to keep down your out-of-pocket spending for health care is to use a hospital and doctor in your health plan’s network. 

But when a medical emergency strikes, you call 9-1-1 and the dispatcher sends the closest ambulance, whether or not it is in-network with your insurance. 

Many ambulances operate without a “network agreement” with health insurance companies for an allowed amount that the health insurance company will pay. 

That means one out of two insured people who use an ambulance for a medical emergency could owe an expensive “ambulance surprise bill” because the ambulance that responded was not in their insurance network. 

These out-of-network balance bills happen when out-of-network ambulances send bills to patients for the remainder of the ambulance bill that their health insurance doesn’t cover. Ambulance surprise bills can be hundreds or thousands of dollars. 

Colorado has a state law that protects patients with state-regulated health insurance plans from ambulance surprise bills, but only if the ambulance is owned by a private company. That leaves many people without protections because in some communities, ambulances are run by the city or county and are considered “public ambulances.” 

Patients who are transported by public ambulances don’t get those surprise billing protections. 

That’s why we support HB25-1088, sponsored by Representatives Karen McCormick and Kyle Brown, and Senators Mark Baisley and Kyle Mullica. 

This bill would extend the Colorado ambulance surprise billing protections to public ambulance services as well. And it includes provisions that ensure ambulances are paid enough to operate efficiently but doesn’t allow overcharges. 

We can’t choose which ambulance responds, but it can make a huge difference in the bill we’ll receive. That’s why Colorado needs HB25-1088 to put an end to ambulance surprise bills no matter which ambulance arrives on the scene or transports you from one hospital to another. 

We believe the solution to surprise billing must include:

• Individual patient protection: Protect the patient from the out-of-network balance bill. Patients cannot choose which ambulance will transport them so they should be protected from out-of-network costs.
• System cost-containment: Ensure ambulances are paid a reasonable rate by our health plans but insurers should not have to absorb overpriced charges from out-of-network providers. Those over-charges could be passed on to our premiums, raising costs for everyone.