Texas Lawmakers seek to protect patients from surprise bills from ambulance rides

AUSTIN, Texas (KBTX) -A report published in Health Affairs revealed that approximately 28% of emergency ground ambulance trips could result in a potential surprise bill, leaving patients with unexpected and excessive charges. Now, Texas lawmakers are taking action to address the issue.

Senate Bill 2476, introduced by Laredo Senator Judith Zaffirini, aims to ensure that patients are not charged exorbitant prices for urgent trips to the hospital. The bill would prohibit municipalities from engaging in balance billing and preclude patients from receiving surprise bills when their insurers refuse to cover the costs.

The legislation has gained support from the Texas EMS Alliance, which says the bill will ensure they are fairly paid for services while avoiding involving patients in payment disputes.

According to Ricky Reeves, a representative of the Texas EMS Alliance, the bill puts the responsibility back on insurance companies to pay a reasonable, adequate rate to EMS providers and lessens the amount that individual patients will have to worry about.

“What we’ve tried to do is get the insurance companies to realize that you are underpaying us extremely, a large amount below the cost of us being able to provide the service so therefore If it’s put back on the insurance company to actually pay a reasonable, adequate rate then it lessens the amount that the individual patient will have to worry about,” said Reeves.

During the Senate committee hearing held on April 12, 2023, Brent Smith, the President of TEMSA and CEO of Hopkins County Hospital District, gave testimony on the bill and conveyed his gratitude towards Senator Zaffirini’s endeavors to safeguard patients and Texas’ vulnerable EMS safety network.

“I want to thank Senator Zaffirini and her staff, along with the Texas Association of Health Plans, for coming together to protect patients and Texas’s fragile EMS safety net,” Smith said. “The committee substitute language that we have been working on collaboratively ensures that local governments – which often help fund EMS operations – retain oversight and accountability. It has safeguards to contain health care spending, and it shields patients who are transported by ambulance from unexpected costs.”

The committee also heard from Keith Muschalek, who says his son received a surprise ambulance bill.

“Last July 27th during a medical incident he was treated at the Seguin Hospital, which is Guadalupe Regional Medical Center. After their diagnosis, they decided to send him to another hospital in San Antonio, TX. That ride was 33 miles. Unannounced to us we had no idea where he went or how he went, “said Muschalek. “Three months later we received a bill for ambulance services in October. That bill which as I said covered the 33-mile drive on I-10 from Seguin to San Antonio. That bill was $4,091.71,” said Muschalek

“Mason was not under a life-threatening situation. It was a non-emergency. It was simply a ride from the hospital there in Seguin to the hospital in San Antonio,” said Muschalek.

Senate Bill 2476 is currently pending a vote to move out of committee.

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