On February 27, 2025, the Oregon State Legislature introduced House Bill 3243, a significant piece of legislation aimed at reforming the billing practices of ambulance service providers. Sponsored by Representative Nosse, along with Representatives Javadi, Pham H, and Senator Patterson, the bill seeks to address the contentious issue of balance billing in emergency medical services.

The primary purpose of House Bill 3243 is to prohibit balance billing for ground ambulance transportation services. This practice often leaves patients with unexpected and substantial medical bills when they receive care from out-of-network providers. The bill mandates that ambulance services cannot bill patients for covered ground transportation if they have already paid the in-network cost-sharing amount specified in their health benefit plan. Additionally, it establishes that insurers must indemnify ambulance service providers directly, ensuring that patients are not caught in the middle of billing disputes.

Key provisions of the bill include the creation of a database to track local rates for ambulance services, which will be maintained by the Department of Consumer and Business Services (DCBS). This database aims to enhance transparency in ambulance billing and allow for penalties against providers who violate the new regulations. The bill also sets limits on out-of-pocket costs for patients, capping them at $100 for both in-network and out-of-network services.

Debate surrounding House Bill 3243 has highlighted concerns from various stakeholders. Supporters argue that the bill is a necessary step to protect patients from exorbitant medical bills and to promote fair billing practices in emergency situations. Critics, however, express concerns about the potential financial impact on ambulance service providers, particularly those that rely on out-of-network billing to cover operational costs.

The implications of this legislation are significant, as it addresses a growing concern among consumers regarding healthcare costs and access to emergency services. Experts suggest that if passed, House Bill 3243 could lead to a more equitable healthcare system in Oregon, reducing the financial burden on patients while promoting transparency in ambulance billing practices.

As the legislative session progresses, the bill will undergo further scrutiny and discussion, with potential amendments and adjustments likely to arise as lawmakers consider the feedback from constituents and industry representatives. The outcome of House Bill 3243 could set a precedent for similar legislation in other states, reflecting a broader movement towards reforming healthcare billing practices nationwide.