Surprise billing, also known as balanced billing by health insurance companies, could come to an end in New Hampshire. That’s the practice of charging patients who use ambulance services the difference between what their insurance covers and what an ambulance company charges.
The New Hampshire House Subcommittee of Commerce and Consumer Affairs passed an amendment to a Senate bill Tuesday that would prevent insurance companies from charging customers beyond their policy coinsurance and deductions for ambulance services.
Think of it this way: You call 911 for an emergency. The ambulance comes, and you know you have a $35 copay, but down the line, you get a bill for additional charges in the hundreds or even thousands of dollars.
Insurance companies sometimes cover only portions of ambulance services, and the remaining balance gets passed off to the patient, who might not have been prepared for or aware of that cost.
If passed, the bill would go into effect on Jan. 1, 2026.
House Commerce and Consumer Affairs Chairman Rep. John Hunt said the move could be unprecedented for insurance companies.
“We're now making them do something that no legislation has ever, ever done, which is force them to fix a rate reimbursement rate,” Hunt said.
Under the proposal, insurance companies would directly reimburse ambulance providers and those payments would be considered in full. A rate would also be established for health carriers to reimburse ambulance services.
Insurance companies would also have to pay a minimum of 3.25 times of Medicaid rates for services if there’s no set rate between service providers and health insurance carriers.
Amendments made to the Senate bill Tuesday include adding a commission to study the costs ambulances are facing under the policy and adjusting rates between ambulances and insurance companies.
Democratic Rep. Carry Spier raised concerns that the bill only addresses one part of the financial problem ambulatory services are facing and questioned if it could be enough to prevent ambulance services from closing. She pointed to the fact that more than 80% of ambulance transports in the state are Medicare or Medicaid patients, which have lower reimbursement rates.
Members of the proposed committee would examine adjustments to the rates ambulances are reimbursed every two years, taking into consideration the inflation rate.
