UT| Utah Insurance Department Bulletin 2025-9, provides guidance to insurers on implementing HB301, which sets payment standards for ground ambulance services effective May 7, 2025. It outlines new regulations for insurers regarding allowable rates for base charges, medications, and mileage for ground ambulance providers, incorporates restrictions against balance billing patients, and requires insurers to review and potentially amend policy and claims processing to comply with the updated legal standards.
Key Points:
- HB301 mandates specific base rates, medication costs, and mileage rates for ground ambulance services, excluding air ambulances, with clearly defined amounts for different levels of emergency transport and procedures.
- Medication charges cannot exceed either the national average drug acquisition cost or Utah Medicaid’s maximum, and mileage rates are capped with provisions for surcharges tied to fuel costs and unpaved travel.
- Insurers must ensure patients are not balance billed for covered ambulance services, update their policies accordingly, and contact the Department for any clarifications.