High Value Health Care

Washington joins 15 other states by enacting ambulance surprise billing protections

States are moving faster than the federal government to protect patients from expensive ambulance surprise bills.

Map of U.S. showing the 16 states with ambulance surprise billing protections March 19 2024
As of March 19, 2024, sixteen states have passed ambulance surprise billing protections

Good news for patients needing emergency transportation in Washington State. On Tuesday Gov. Jay Inslee signed into law strong new ambulance surprise billing protections, which will go into effect next year. Washington joins 15 others states which have passed laws to protect patients from expensive out-of-network ambulance bills. 

The bill got a needed boost on January 12, 2024 when Christy Shum shared her story with a state legislative committee. She recounted her shock when she received a $7000 ambulance bill after her newborn who was having breathing issues was transported by ambulance from her local hospital to the nearby children’s hospital. Even though she and her husband had  insurance, because hospital ordered an ambulance that was not part of their insurance network, their health plan only covered $1,000. That left her with a whopping $6,000 left to pay out-of-pocket. PIRG also testified at the hearing, explaining that patients have no control over the choice of ambulance and should not be penalized with these huge bills. People who need ambulances have a high risk of receiving a surprise bill because about 50 percent of ambulance rides are provided by an ambulance outside of insurance networks.  

“Many patients in Washington will no longer need to fear unknowable, expensive surprise bills from ambulances the next time they experience a medical emergency,” said Patricia Kelmar, PIRG’s Health Care Campaigns senior director. “We applaud the swiftness with which Washington studied and addressed this gap in surprise billing protections.”

Beginning January 1, 2025, Washington’s new state law will ban out-of-network ambulance surprise bills for patients who receive emergency medical treatment at the scene or are transported to another site for emergency treatment. Patients will only pay their in-network cost-sharing amount. The law applies to patients who are insured by state-regulated insurance plans. 

A federal law, the No Surprises Act, protects patients from other common surprise bills as of January 2022. But it didn’t address ground ambulances. Instead the federal law established a Ground Ambulance and Patient Advisory Committee, which includes Kelmar, to make recommendations to Congress. We expect the recommendations and report from that federal committee by summer. 

But states aren’t waiting for a federal solution.  Indiana’s Gov. Eric Holcomb signed its bill on March 13. While state laws help some insured patients, a federal solution is still needed to extend ambulance surprise bill protections for people enrolled in employer-sponsored insurance plans.

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