California’s 2024 Law Eliminates Unexpected Ambulance Fees
TL/DR –
A new California law is expected to save residents tens of millions of dollars by forcing insurance companies to negotiate payments for “surprise” ambulance bills which often leave families in debt after a medical emergency. The law, which took effect from January 1st, addresses out-of-network charges for commercially insured patients who have no control over which ambulance company responds to a call for help. Patients will only have to pay the equivalent of what they would have paid for an in-network service and health insurance and ambulance companies will have to settle the bill directly, even if they don’t have an existing contract.
Surprise ambulance bills: New California law aims to alleviate burden
Unforeseen ambulance bills can spiral families into debt following a health crisis. A fresh California state law compelling insurance firms to negotiate payments is forecasted to save Californians millions annually.
Danielle Miele’s family felt the hefty impact of the COVID-19 pandemic, and after receiving two hefty ambulance bills, she now fears dialing 911. In 2022, her teenage son suffered a severe mental health crisis, needing an ambulance transfer from Roseville emergency room to a treatment facility in San Mateo. The ambulance company issued Miele a $9,000 out-of-network charge, which quickly led to debt collections.
Miele has also experienced seizures mimicking heart attack symptoms due to COVID-19. Despite insurance, a 15-minute ambulance ride to the hospital cost $4,000. The high medical costs have deterred her from using ambulance services again.
A new law in California, effective from January 1, aims to address such “surprise” ambulance bills that leave insured families like Miele’s in debt. The law mandates that patients only pay the equivalent of in-network costs, with health insurance and ambulance companies required to settle the bill directly. Supporters argue this can make a significant difference to thousands of families.
Californians hit with millions in surprise bills
Despite opposition from California Association of Health Plans citing potential premium increases, the benefits to commercially insured patients are significant. They could save approximately $44.5 million in direct ambulance charges according to legislative analysis.
Katie Van Dynze, a legislative advocate for Health Access California, highlighted the law’s role in closing a crucial gap in California’s consumer protections against surprise medical billing. The law extends protections to about 14 million Californians with state-regulated commercial health plans. According to Kaiser Family Foundation, in 2018, 73% of all ground ambulance transports resulted in out-of-network charges among people with large employer insurance. Moreover, California has the country’s highest median surprise ambulance bill at $1,209.
$4,400 bill for newborn’s ambulance trip
A case illustrating the impact of these surprise bills involves the Arebalo family from San Luis Obispo County. After Lainey Arebalo gave birth to her son Brady, he was immediately transferred to a larger hospital due to breathing issues, resulting in a $4,400 ambulance bill. Despite insurance covering a large portion of Brady’s hospital stay, the out-of-network ambulance ride wasn’t covered. The unexpected bill forced Arebalo to end her maternity leave early to pay off the debt, which she is still repaying through a monthly payment plan.
However, roughly 6 million Californians enrolled in federally regulated health plans won’t be protected by this law. A national committee is currently working on a solution to the U.S. No Surprises Act, which shields Americans from various surprise bills, excluding ground ambulance rides.
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