Balance Billing of Patients Covered by Health Benefits Plans for Ground Ambulance Services is Prohibited

Hugh McDonald SECRETARY OF COMMERCE * AID "="" * a,* BULLETIN # 5-2024 DATE: May 1, 2024 TO: Alan McClain COMMISSIONER, ARKANSAS INSURANCE DEPARTMENT ALL LICENSED HEALTH INSURERS, HEALTH MAINTENANCE ORGANIZATIONS, HOSPITAL AND MEDICAL SERVICES CORPORATIONS„ SPONSORS OF NONFEDERAL SELF-FUNDED GOVERNMENTAL PLANS, AND GROUND AMBULANCE PROVIDERS RE: BALANCE BILLING OF PATIENTS COVERED BY HEALTH BENEFIT PLANS FOR GROUND AMBULANCE SERVICES IS PROHIBITED The Arkansas Insurance Commissioner ("Commissioner") issues the following advisory pertaining to recent legislation enacted by the Arkansas General Assembly in 2023 concerning ground ambulance billing, specifically the balance billing portions of Acts 578 and 597 of 2023. "Balance billing" refers to a practice in which a provider bills an insured for the difference between the provider's charge and the amount allowed by the insurer. When insureds are balance billed for ambulance service, they are often unable to afford these additional charges, leading to medical debt and other serious financial and health repercussions. The Arkansas General Assembly prohibited balance billing by ground ambulance service providers through passage of Acts 578 and 597 which became effective on August 1, 2023. These Acts apply to any ground ambulance service provider providing services to an insured with a plan subject to state jurisdiction. Simply put, for any plan defined as a "health benefit plan" by Ark. Code Ann. § 23-99-1702 or § 23-99-1801, a ground ambulance provider shall not balance bill or otherwise demand a payment from the insured other than a deductible, copayment, or coinsurance required under the insured's health benefit plan. Please see Ark. Code Ann. § 23-99-1705 and § 23-99-1802. For any questions related to this Bulletin, please contact insurance.legal@arkansas.gov. 0 Li ALAN MCCLAIN DA ARKANSAS INSURANCE COMMISSIONER 1