One of the most impactful health consumer bills this year, AB 716 (Boerner) will prevent Californians from getting $1,000 plus surprise ambulance bills, and take consumers out of the middle of ambulance billing disputes
***Impacted consumer stories available upon request***
SACRAMENTO, CA – Today California Governor Gavin Newsom has signed AB 716 by Assemblymember Tasha Boerner to end a major loophole in state and federal surprise billing protections and allow Californians to call 911 for an ambulance without the concern of a large bill. The new law–which will go into effect on January 1, 2024–will prevent surprise out-of-network bills for ambulance rides.
Millions of Californians have received large bills after taking an ambulance that was unknowingly out-of-network. These surprise bills, often over $1,000, can be financially destabilizing, especially for low- and moderate-income Californians who lack significant savings. As a result, many Californians have reported hesitation to call an ambulance at all for fear of a huge bill, putting their health at risk. The new law will limit how much Californians will have to pay to the in-network cost-sharing of their health plan, or in the case of the uninsured, the Medicare or Medi-Cal rate, whichever is greater.
Over the last decade, California and the federal government have banned surprise out-of-network charges for most medical bills, including from doctors, hospitals, and air ambulances; but up until now, these patient protections excluded ground ambulance bills. The new law will prevent private insurers and ambulance providers from billing patients more than their in-network cost-sharing for emergency and non-emergency ambulance services. When a contract is not present, insurance plans will pay ambulance providers the locally-set rate for services. Those without insurance will now not be charged more than the Medi-Cal or Medicare rate for ambulance services, whichever is greater. The law will also protect consumers from being sent to collections and receiving an adverse credit report for an unpaid bill or being sued for 12 months after receiving the first billing notice. Additionally, consumers will be protected from wage-garnishment and from having a lien placed on their primary residence during collections, in line with existing protections for out-of-network bills from health professionals.
***Impacted consumer stories available upon request***
“With Governor Newsom’s signature of AB 716, Californians are finally protected from the trauma of being hit with a large ambulance bill after already facing the trauma of an emergency,” said Katie Van Deynze, policy and legislative advocate with Health Access California, the statewide health care consumer advocacy coalition which sponsored the bill. “We’ve heard from Californians across the state who have been hit with these unexpected bills when a family member needed an ambulance. People think it’s a mistake because they have insurance, only to find out that California law allows these large bills to be charged to consumers, and they have to figure out how to pay it. Some consumers may decide to not call an ambulance in the next emergency. This new law will provide direct benefits to millions of Californians, giving them the peace of mind to know that they can call 911 in an emergency without the threat of a huge surprise bill.”
“Surprise medical bills are a failure of the health care system. Patients are charged exorbitantly high prices by providers who people didn’t know were out-of-network,” said Jenn Engstrom, State Director of CALPIRG, a key supporter of the bill. “Thanks to this legislative action, when it comes to surprise ambulance bills, Californians will soon make sure that protecting their physical health isn’t so detrimental to their financial health. We thank Assemblymember Boerner for her leadership on this issue and Governor Newsom for signing critical legislation into law.”
“The last thing anyone should be thinking about during a medical emergency is whether they can afford the ambulance ride,” said Assemblymember Boerner, author of AB 716. “AB 716 prevents consumers from being hit with those surprise bills for ground ambulance service, protects the uninsured, and helps ensure that the costs are better covered for the heroic work of our firefighters and paramedics. I was proud to see the Governor sign it into law today!”
Ambulances have the highest-out-network billing rate in the country, adding up to $129 million spent by insured patients on ambulance surprise bills every year nationally. Studies show more than two-thirds of California patients with large employer coverage had an out-of-network ambulance bill. After an ambulance ride, California patients often receive a surprise bill of over $1,000 and even more than $2,000 depending on the provider and insurer.
By taking the consumer out of the middle of disputes between ambulance providers and health plans, this new law will prevent Californians from being charged an out-of-network surprise bill for ground ambulance services and protect uninsured Californians from being charged inflated ambulance rates.
Currently experiencing a surprise ambulance bill? Contact Health Consumer Alliance via their Website or Consumer Hotline: 888-804-3536. If you receive a bill over your in-network cost-sharing after January 1, 2024, contact the Department of Managed Health Care via their Website or Help Center: 888-466-2219