Legislation to Protect Patients from Surprise Ambulance Billing Passes Committee
DENVER, CO – The House Health & Human Services Committee today passed legislation to protect patients from surprise ambulance billing. HB25-1088, sponsored by Representatives Karen McCormick and Kyle Brown, would shield Colorado patients by expanding existing consumer protections to public ambulance services.
“No one should hesitate dialing 9-1-1 during an emergency because they’re concerned about cost,” said Rep. Karen McCormick, D-Longmont. “This bill aims to extend surprise billing protections to public ambulance service so Coloradans can receive the emergency services they need. Our bill would establish clear reimbursement rates and ensure that when patients require an ambulance, they aren’t later charged unreasonable and often unaffordable bills.”
“The last thing on someone’s mind when calling an ambulance during an emergency should be cost – yet many patients still receive expensive, surprise bills from ambulance services,” said Rep. Kyle Brown, D-Louisville. “This important legislation extends consumer protections to cover surprise billing from public ambulance services. Keeping our communities safe and healthy is a top priority, and this legislation makes sure Colorado patients won’t face surprise ambulance bills that they cannot afford.”
HB25-1088 passed committee by a vote of 12-1. This bill would protect patients from surprise, and typically expensive, ambulance billing. Colorado’s existing billing protections only include private ambulance services. HB25-1088 builds upon previous bipartisan legislation to protect patients from surprise ambulance billing by extending protections to public ambulance services.
Additionally, this bill would put key federal Advisory Committee on Ground Ambulance and Patient Billing (GAPB) recommendations in place, such as:
- Prohibiting all ambulance agencies from balance billing patients for both emergency and non-emergency transports.
- Establishing reimbursement rates for ambulance services that are out of network.
- Requiring carriers to pay the rates adopted by governing political subdivisions, assuming those rates meet conditions designed to improve transparency and limit costs.
- Creating a public-facing website of rates adopted by political subdivisions.
- Ensuring ambulance agencies are paid directly after a transport.
During an emergency, patients cannot choose who responds to their 9-1-1 call, and more than 75 percent of ambulance agencies in Colorado are public departments not covered by current law. The bill establishes clear reimbursement rates to ensure patient access and improves ambulance sustainability in all Colorado communities.
During testimony, Kevin McFatridge, Executive Director of the Colorado Association of Health Plans (CAHP), expressed appreciation for the intent of HB25-1088 but emphasized the need to distinguish between emergent and non-emergent transport services.
“Emergency ambulance transport requires highly trained personnel, rapid response, and life-saving interventions. Non-emergent transport, on the other hand, does not require the same level of urgency or medical expertise,” McFatridge stated. “Applying the same reimbursement structure to both is not appropriate. We urge lawmakers to establish a separate, reasonable reimbursement rate for non-emergent transport to prevent excessive costs that ultimately impact consumers and premiums.”
McFatridge also raised concerns about the potential for increased non-emergent transport usage if reimbursement is guaranteed without appropriate limitations. “Without guardrails, ambulance providers could have a financial incentive to increase non-emergent transport that is not medically necessary. This would drive up healthcare costs unnecessarily,” he warned.
Additionally, CAHP highlighted the importance of placing oversight and enforcement within the appropriate regulatory framework. “Oversight and enforcement of ambulance rates and protections against balance billing should not fall under the Division of Insurance, which does not regulate ground ambulance services. Instead, we recommend a stakeholder process—similar to what DOI convened for private ambulance rates—to develop an appropriate reimbursement model for non-emergent transport,” McFatridge explained. “This process should involve the Colorado Department of Public Health and Environment (CDPHE), as it is better positioned to oversee enforcement in this space.”
With these recommended amendments, HB25-1088 can more effectively balance fair reimbursement with preventing unnecessary cost inflation. The Colorado Association of Health Plans looks forward to working with stakeholders to refine the bill and ensure sustainable solutions for both patients and the healthcare system.
