March 2024 Advocacy Update
HB24-1218 Ground Ambulance Rates Fails to Advance in the Colorado House
By John Seward, Vice Chairman of Advocacy Committee
Regulatory Compliance Officer & EMS Program Manager at the University of Denver
On March 19, 2024, the Colorado House Committee on Health and Human Services chose not to advance House Bill 24-1218 concerning costs of providing ground ambulance services, until after session – effectively killing the bill. This bipartisan bill sought to end the practice of surprise billing in ambulance service and resolve ongoing struggles between EMS agencies and insurance companies.
EMSAC led the charge in support of the bill, and we were joined by the Colorado Consumer Health Initiative, the Colorado Hospital Association, Common Spirit Health, and the Special District Association of Colorado. Not surprisingly the bill was opposed by the health insurance industry.
HB 1218 was modeled after legislation passed in Texas, California, and Louisiana, states that tend to be on opposite sides of many political issues. By ending surprise billing and requiring insurance plans to promptly pay EMS agencies the local advertised rate for services as reported to the Division of Insurance or 325% of Medicare, the bill sought to resolve the decades old problem of health insurance choosing not to pay EMS for the essential medical services we provide.
While lots of hard work went into the drafting and lobbying for HB 1218, ultimately there were too many competing stakeholders with visions of different approaches to the legislation. Given the time crunch of the legislation session and lack of understanding from legislators about how the EMS system works, the legislation needed more time to thread the needle and determine the best path forward. EMS is not like most healthcare providers - we don’t choose our patients, and we don’t check their insurance status before getting them into an ambulance. By definition, EMS is an emergency and there’s no time to get preauthorization while our patients are experiencing a heart attack or suffering from a head injury, because they need expert care and they need it fast.
EMSAC remains opposed to surprise billing and is committed to finding a solution that gets EMS paid for our vital services and takes the patient out of the middle of insurance billing. While this is a setback, our fight has only just begun. We look forward to helping legislators understand how EMS actually works.
