Expands current balance billing prohibitions to include ground ambulance services. Rather than applying the independent dispute resolution process, SB 2476 directs TDI to create an emergency service provider balance billing rate database. Health plans must reimburse ground ambulance services at:
- A rate set, controlled, or regulated by a political subdivision if the entity has submitted the rate to the TDI database (with an annual increase per Medicare Inflation Index, not to exceed 10%); or
- The lesser of the billed charge or 325% of Medicare.
Effective September 1, 2023. The changes apply on or after January 1, 2024. TDI will adopt rules.
