California Assembly Bill 716 (AB716) will be implemented on January 1, 20, and 24. It introduces important changes in ground ambulance billing and offers improved protections for injury victims. These updates are designed to eliminate surprise medical bills and ensure fair billing practices, particularly in emergencies, allowing patients to focus on healing rather than navigating financial stress.
The 2024 updates to AB 716 ambulance billing protections offer much-needed support and clarity for those affected by an accident or medical emergency. The new provisions protect insured and uninsured individuals from unfair collection tactics and restrict out-of-network ambulance service providers from charging excessive rates. Both healthcare professionals and injury victims praised these reforms.
Dates for Effectiveness and Key Provisions
AB 716 took effect on the first day of 2024. The bill requires that any health insurance policy issued, renewed, or amended after January 1, 2024, adhere to the new billing regulations regarding ground ambulance services. This bill, in particular, repeals Section 10352 (of the Insurance Code), which allowed ambulance service providers to charge patients directly for non-network services.
Under the new legislation, patients are responsible only for the amount they share in the network, even if their ambulance service is outside the network. A ground ambulance provider that is not contracted cannot send patients into collections for any amount above the in-network cost-sharing. This protection also extends to uninsured and self-paying patients. These patients cannot be charged anything more than what is established by Medi-Cal, Medicare or the fee-for-service amounts.
Changes To The Regulatory Framework And Oversight
AB716 requires the California Emergency Medical Services Authority to report annually on the allowable maximum rate for ground ambulance services in California counties. The report must include a trend analysis by county. This annual report, due no later than March 1, 2024, or earlier, will provide transparency in the rate review. The report goes to the Department of Insurance for further evaluation.
Personal Injury Victims And The Impact On Their Lives
1. Reduced Economic Burden
Ambulance bills can be very expensive for those with personal injuries. AB716 helps to ease this burden by ensuring patients are not liable for any out-of-network charges above their in-network co-payment. This change will allow victims to focus solely on their recovery without being burdened by unexpected medical expenses.
2. Simplified Insurance Claim
Insurance companies now have to settle their out-of-network fees directly with ambulance services. This will streamline the billing process, reduce patients’ administrative burden, and lead to more efficient claim processing.
3. Enhanced Protections for Consumers
The law prohibits ambulance companies not contracted with the network from reporting any unpaid amounts or bringing civil actions in court against patients who owe more than the cost-sharing amount. Providers must also wait 150 days from the initial billing date before pursuing collection. These protections guard personal injury victims from aggressive debt-collecting practices.
4. Support For Uninsured or Self-Pay Patients
AB 716 offers protection for uninsured personal injury victims or those who self-pay. They can’t be charged anything more than Medi-Cal fees or Medicare service charges. This law ensures that people without insurance will not be charged exorbitant amounts for ambulance services.
What Victims of Personal Injury Should Do
To benefit fully from AB 716 protections for victims of personal injuries, you should:
- Verify Ambulance Provider Networks
Confirm with your insurer if they have a contract for the ground ambulance. In this case, you will not be charged any more than your cost-sharing amount.
- Check Medical Bills Carefully
Examine each medical bill to make sure it is accurate. Also, check that all charges adhere to the new billing standards. Dispute any discrepancies quickly with your insurer and the ambulance services.
- Seek Legal Assistance If Necessary
If you experience billing or collection issues that violate AB716, consider consulting a Personal Injury Attorney. Legal professionals offer support and guidance to help resolve disputes and ensure laws are followed.
Conclusion
The 2024 updates to AB716 represent a significant step forward in California’s consumer protection for personal injury victims. The law helps to reduce financial stress by prohibiting the balance billing of ambulance services and restricting out-of-network charges. These changes will allow people to focus more on recovering than worrying about unexpected expenses. Personal injury sufferers must be familiarised with these benefits to ensure they receive their full entitlements under AB716.