The House Commerce and Consumer Affairs Committee of the New Hampshire Legislature convened on May 27, 2025, to discuss critical issues surrounding emergency medical services (EMS) and the financial challenges faced by ambulance providers. The meeting highlighted the urgent need for legislative reform to address the ongoing billing disputes that have left patients and providers in a precarious situation.

A key focus of the meeting was Senate Bill 245, introduced by a legislator who is also a nurse with extensive experience in emergency care. The bill aims to rectify the problems stemming from the exclusion of EMS from the 2020 federal No Surprises Act, which has resulted in patients receiving unexpected bills after emergency services. The legislator emphasized that when individuals call 911, they expect timely care without the burden of financial uncertainty.

Senate Bill 245 proposes several significant changes: it prohibits balance billing by out-of-network ambulance providers and mandates that insurance companies pay a fair rate for emergency transports. This rate would either be the locally approved rate or at least 325% of Medicare rates if no local rate is established. The bill also ensures prompt payment for emergency services, eliminates the need for prior authorization, and presumes that services dispatched by protocol are medically necessary.

Additionally, the bill includes a provision for a two-year independent cost study to accurately assess ambulance costs and introduces an "any willing provider" model, allowing ambulance companies to join insurance networks. This is seen as a necessary step to ensure that emergency transportation is treated as an essential service rather than a luxury.

The committee members engaged in a discussion regarding the bill, ultimately voting in favor of the motion to pass the bill as amended. The roll call vote showed unanimous support from all present members, indicating a strong consensus on the importance of stabilizing EMS funding and ensuring fair reimbursement for ambulance services.

In conclusion, the meeting underscored the critical nature of emergency medical services in New Hampshire and the legislative efforts underway to protect both patients and providers from financial distress. The passage of Senate Bill 245 is viewed as a vital step toward ensuring the sustainability of ambulance services across the state.