In a recent meeting of the New Hampshire House Commerce and Consumer Affairs Committee, significant discussions centered around proposed reforms for ground ambulance services, aiming to address long-standing reimbursement issues. The proposed legislation seeks to establish a cost-based rate schedule for commercial payers, which would be mandatory for reimbursing out-of-network ground ambulance providers. This initiative is part of a broader effort to ensure that ambulance services are adequately compensated for their operations.

One of the key components of the proposal is the prohibition of balance billing, which has been a contentious issue for consumers who often face unexpected charges after receiving ambulance services. By eliminating balance billing, the legislation aims to provide greater financial clarity and protection for patients.

Additionally, the proposal includes the formation of a commission to explore the feasibility of an all-payer model for ground ambulance services. This model would create a unified reimbursement schedule for Medicare, Medicaid, and commercial payers, similar to systems already in place in states like Maryland. The goal is to ensure that reimbursement rates are fair and sustainable, while also maintaining cost neutrality for the federal government.

The discussions highlighted the importance of a comprehensive cost study, mandated by last year's Senate Bill 407, which has been conducted by the consulting firm PCG. This study utilized data from existing Medicare cost surveys to develop a rate schedule that reflects the actual costs incurred by ground ambulance providers. The proposed rates would represent a significant increase—doubling what commercial payers currently reimburse, and exceeding 200% of Medicare rates.

Committee members expressed the need for transparency in how these rates are determined and the implications for both providers and consumers. While the proposal aims to balance the financial burdens between insurance carriers and ambulance providers, it also emphasizes the necessity for providers to adapt their business models for long-term sustainability.

As the committee prepares to move forward, the discussions underscore the complexity of healthcare reimbursement systems and the ongoing challenges faced by ground ambulance services. The anticipated next steps include further analysis by a super subcommittee, which will refine the proposal and address any outstanding concerns from stakeholders. The outcome of these discussions could set a precedent for how ground ambulance services are reimbursed in New Hampshire and potentially influence similar reforms in other states.