HB 3243
Prohibits balance billing for ambulance ground transportation services in certain circumstances and creates rules for health benefit plan reimbursement of ambulance services.
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Sign in to take actionPublic sentiment
Support
82%
Oppose
18%
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill aims to protect patients from ‘balance billing’ for ambulance ground transportation services. It requires ambulance services to report local rates to the Department of Consumer and Business Services (DCBS) and establishes a public database of these rates. The bill also mandates that health benefit plans reimburse ambulance services at established local rates or at least 400% of the Medicare rate, and limits out-of-pocket costs for patients.
Key provisions
- Amends ORS 743A.014 to prohibit ambulance services from billing patients for covered ground transportation.
- Requires ambulance services to submit established local rates to DCBS annually.
- Creates a public database of ambulance rates maintained by DCBS.
- Limits out-of-pocket costs for patients to $100 for in-network or out-of-network providers.
- Requires health benefit plans to provide an explanation of benefits detailing cost-sharing amounts.
- Allows DCBS to impose civil penalties for violations of the bill.
- Specifies that the bill applies to self-funded group health plans that opt-in to the regulations.
Who is affected
- Ambulance service providers
- Health benefit plan administrators
- Enrollees in health benefit plans
- Patients receiving ambulance services
- The Department of Consumer and Business Services
Notable changes
- Prohibits balance billing for ambulance ground transportation services.
Sponsors
Official sponsors from legislative records.
Primary sponsor
Cosponsors
Arguments in favor
Reasons to support this legislation.
Supporters of House Bill 3243 emphasize the need to protect patients from balance billing for ground Emergency Medical Services (EMS) and ensure fair reimbursement for transport agencies facing financial challenges. They argue that this legislation addresses a significant concern among consumers who face surprise medical bills from out-of-network ambulances, highlighting the importance of consumer protection in healthcare. Proponents also note that the bill aims to strengthen EMS services across the state by enhancing emergency response capabilities, supporting frontline workers, and ensuring access to high-quality emergency medical services. By stabilizing and strengthening EMS services, supporters believe this legislation will ultimately improve public health and safety outcomes.
Source: Testimony Summaries
Arguments opposed
Reasons to oppose this legislation.
Opponents of House Bill 3243 express concerns that the proposed legislation would not adequately address the issue of balance billing, as it may not provide a definitive substitute for contractual reimbursement rates and could lead to unintended consequences. They argue that patients should not be held liable for balance billing, citing the PacificSource companies' assertion that balance billing is an unfair practice. Additionally, some the need for greater transparency and predictability in healthcare pricing, highlighting the potential risks of the bill's provisions on patient financial stability and access to necessary care.