Colorado lawmakers are pushing forward with a new bill aimed at protecting residents from unexpected ambulance bills, an issue that has burdened many patients across the state. The proposed legislation, House Bill 25-1088, recently passed the House Health and Human Services Committee with bipartisan support, moving one step closer to becoming law.
Addressing the Gaps in Current Law
Colorado already has laws in place to prevent surprise medical bills from privately owned ambulance services. However, the existing regulations do not apply to publicly operated ambulances, leaving many patients vulnerable to unexpected out-of-network charges.
Under the proposed bill, insurance companies would be required to pay pre-determined rates set by local agencies for ambulance services, ensuring that patients are not left with unexpected expenses. Currently, some Coloradans face steep charges when using public ambulances because their insurance categorizes the transport as out-of-network.
The new measure aims to fix this loophole by standardizing how ambulance services are reimbursed, regardless of whether the ambulance is privately or publicly operated.
A Personal Story Highlights the Issue
Lee Herndon, a Denver resident, is among those who have faced the financial shock of an unexpected ambulance bill.
“In 2023, I experienced an emergency health condition and knew I needed help, so I called 911,” Herndon recalled. “I got a quick ride from my home in Cap Hill to St. Joe’s, and a few months later, I was hit with a $1,500 ambulance bill.”
Despite having insurance, Herndon was charged out-of-pocket for the ambulance ride. After months of back-and-forth with his insurance company and the ambulance provider, he sought help from the Colorado Consumer Health Initiative (CCHI) to resolve the issue.
“This was a complete surprise to me. I thought the law already protected us from this kind of billing,” he added.
How the Bill Would Work
If passed, HB 25-1088 would:
- Require insurance companies to cover ambulance services at rates set by local agencies, preventing out-of-network charges.
- Establish a process for ambulance providers to seek reimbursement for cases where a patient’s insurance does not cover the full cost.
- Close loopholes that currently allow public ambulance services to bill patients directly, ensuring that emergency transport is not a financial burden.
Policy advocates believe the bill will bring much-needed relief to Coloradans who find themselves in emergency situations.
“It’s a commonsense reform,” said Isabel Cruz, Policy Director at CCHI. “People should be able to focus on their health during an emergency—not worry about whether they can afford the ambulance ride.”
Opposition from Insurance Providers
While the bill has received widespread support from counties and consumer advocacy groups, some health insurance companies are pushing for amendments.
Kevin McFatridge, Executive Director of the Colorado Association of Health Plans (CAHP), testified before lawmakers, arguing that the bill does not distinguish between emergency and non-emergency ambulance transport.
“Emergency ambulance transport requires highly trained personnel, rapid response, and life-saving interventions,” McFatridge said. “Non-emergency transport, on the other hand, does not have the same level of urgency or medical expertise. We believe these services should have different reimbursement rates to avoid excessive costs.”
CAHP is asking legislators to introduce separate regulatory frameworks for emergency and non-emergency transport to prevent potential overuse of the system.
Next Steps for the Bill
With a strong 12-1 vote in favor at the House Health and Human Services Committee, the bill now heads to the House Appropriations Committee for further consideration.
Lawmakers from both parties have expressed optimism about the bill’s chances, citing its potential to protect residents from unexpected financial burdens in critical medical situations.
“Medical emergencies are stressful enough without the added worry of a massive ambulance bill,” said one lawmaker. “This bill is about ensuring fairness and financial protection for all Coloradans.”
If the legislation passes, Colorado will join other states in expanding consumer protections against surprise medical billing, reinforcing the state’s commitment to affordable and accessible healthcare.
(Source : newsbreak.com)
