NC House unanimously caps costs for emergency ambulance rides

The North Carolina House of Representatives unanimously passed House Bill 489 on Tuesday, a measure aimed at protecting residents from exorbitant ambulance bills by ensuring insurance companies recognize rates set by local governments. 

The bill requires health-insurance plans to cover out-of-network emergency ambulance services without prior authorization in emergency situations. It passed in a 111-0 vote, aiming to protect citizens from financial burdens for emergency services they cannot control.

“Currently, more than half of all ambulance rides include an out-of-network charge,” said state Rep. Donnie Loftis, R-Gaston. “And in fact, 8% of medical debt in the USA is the result of ground ambulances. And so this bill addresses that no surprise billing down the road for a patient who’s transported by ambulance.”

In one case, Loftis described a baby who was flown 97 miles, and the bill was $97,000. In another case, a COVID patient was flown 86 miles, and the bill was $82,000, which was billed to his estate when he died.

Rates charged by counties for emergency medical services (EMS), whether provided directly or through contracted providers, must be honored by insurers. It sets a minimum reimbursement rate for services at 100% of the local government-approved rate, or, if none exists, either 400% of the Medicare rate or the provider’s billed charges.

“Citizens should not be responsible for paying this increase because they already pay their taxes in the county’s contract with EMS services,” Loftis said. “This will fix some surprise billing for emergency transport when we have no options.”

The bill draws on a 2024 congressional advisory committee’s findings, which recommended a payment hierarchy to require insurers to accept state and local EMS rates.

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