Legislation to fix surprise medical billing won’t apply to ground ambulances, but may produce data that will spur their inclusion

The congressional fix for surprise medical bills, contained in the legislation to keep the government open, provide pandemic relief and do many other things, does not apply to ground ambulances, which “have the highest out-of-network billing rate of any medical specialty,” The New York Times reports.

Congress “had little data on the actual costs of ambulance trips, and worried about tussling with the local governments that often oversee these services — especially those whose budgets have been battered by the economic downturn,” Sarah Kliff and Margot Sanger-Katz report for the Times.

Research by Dr. Karan Chhabra of Boston’s Brigham and Women’s Hospital found 71 percent of ambulance rides “have the potential to generate a surprise bill, with an average cost to the patient of $450,” the Times reports. “Whether an ambulance company chooses to pursue this bill is something his research cannot determine, which is why it is merely potential.” An earlier study found most ambulance rides “resulted in an out-of-network bill, a substantially higher rate than the medical specialties that the new legislation covers.”

In the world of surprise medical bills, $450 is relatively small, and many ambulance services write off unpaid out-of-network bills as bad debts. But the new Congress could extend the new law — which President Trump signed Sunday night and will take effect in 2022 — to include ground ambulances.

“Medicare, which pays ambulances set rates and bans surprise billing for the patients it covers, is reviewing its payment rates,” the Times reports. “As part of that process, the government is collecting detailed data from ambulance companies about their costs and prices. And the surprise-billing legislation passed this week establishes a commission to study the problem of ground ambulance bills, another way for lawmakers to learn more about how things are currently working.”