Ambulance Surprise Billing Gap

Summary

This article discusses the gap in the No Surprises Act concerning ground ambulance services, which often leads to unexpected, high medical bills. It explores the reasons for this exclusion, the impact on patients, and potential solutions. The article also highlights the work of a federal advisory committee tasked with addressing this complex issue and suggests future steps.

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** Main Story**

Alright, let’s talk about something that’s probably annoyed you, or someone you know: ambulance surprise billing. It’s a real problem, and even though the No Surprises Act was supposed to fix things, it kind of… missed a spot.

See, back in December 2020, the No Surprises Act came into being with the best intentions. Basically, it was meant to shield us from those crazy unexpected medical bills you get from out-of-network providers. You know, like when you rush to an out-of-network hospital in an emergency, or even when you see an out-of-network doctor while you’re at an in-network facility. Sounds good, right? Except, it doesn’t cover ground ambulances. Seriously!

The Ambulance-Sized Loophole

It’s frustrating, I know. And it leaves people open to getting these ridiculous bills. I mean, who wants to worry about money when they’re dealing with an emergency? It even stops some people from calling for help when they really need it, that’s the bit that is actually dangerous.

So, why the heck were ground ambulances left out? Well, it’s complicated. The thing is, ambulance services are all over the place. Some towns run their own, others hire private companies – everything from huge corporations to your local family business. Because it’s such a mixed bag, it’s hard to make one set of rules that fits everyone. Congress knew it was a mess, so they told a bunch of government departments—Labor, Health and Human Services, and the Treasury—to get a committee together, study the problem, and come up with some answers.

The GAPB Committee Steps In

This led to the creation of the Ground Ambulance and Patient Billing (GAPB) Advisory Committee. They got together a few times in 2023 and finally put out a report in August 2024. You know what they suggested? Things like making billing clearer and teaching people about their insurance options for ambulances. One big thing they said was that ambulance companies shouldn’t bill patients directly until after the insurance company has dealt with the claim. On top of that, they thought there should be a limit on how much patients have to pay, like a set amount that goes up each year with inflation, or a percentage of the total cost – whichever is lower.

The Real-World Impact: A Story

I remember a friend telling me about their mom, she’s on a fixed income and needed an ambulance after a fall, she ended up with a bill that was more than her monthly rent. It’s just insane, isn’t it?

And, the current situation? Honestly, it’s awful. People are getting buried in debt because of these bills, and it causes so much stress. Some folks even avoid calling 911 because they’re scared of the cost. It’s a real public health risk. It’s often older folks who are hit the hardest because they’re more likely to need an ambulance, plus they’re often on fixed incomes.

What Can We Do About It?

Okay, so the GAPB committee made some suggestions, but Washington hasn’t done anything with them yet. Some states have tried to protect people from these surprise bills, but their rules are all different and sometimes even make healthcare more expensive overall. Experts have a few ideas, though. Standardizing billing, making prices clearer, and setting up a way to handle disputes like they do with other out-of-network services are some options.

So, what’s the solution? I think we need some action. The loophole in the No Surprises Act is still hurting people, and we need some laws to fix it. We have to think carefully about the ambulance business and make sure everyone has fair access to emergency transport. It’s not an easy fix, but it’s something we definitely have to do.