Written By Chris Dolan and Alison Baird
This week’s question comes from Bruce from Marin County, CA, who asks: Last weekend, I encountered an injured bicyclist while I was riding my bike on a local mountain trail. He said he may have a broken rib and needed help to get down the mountain. I called 911, and they told me they would dispatch help. A CHP helicopter arrived 15 minutes later with a medic, and the ranger came soon after. Through the frenzy, I heard the medic tell the injured rider they would have to airlift him to the hospital immediately. He added, “Don’t worry, you don’t have to pay for the ride”. Thankfully, the injured cyclist would recover from his injuries. After all of this, I wondered about the cost of the emergency airlift. Are injured people obligated to pay for an emergency medical transport helicopter? Does the same apply to an ambulance ride? Who is covering the costs?
Your quick thinking undoubtedly helped that injured bicyclist. To answer your question, in California, the California Highway Patrol (CHP) covers the cost of any airlift they provide. The CHP Air Operations Unit provides emergency medical transport services to citizens in medical emergencies, and their CHP budget covers the expenses. An ambulance ride is another matter.
Ambulances have the highest out-of-network billing rate in the country, adding up to $129 million spent by insured patients on ambulance surprise bills every year nationally. Over two-thirds of California patients with significant employer coverage had an out-of-network ambulance bill. California patients often receive a surprise ambulance bill of over $1,000, sometimes $2,000, which can financially destabilize some families. Fearing an unexpectedly large bill, sick or injured people risk their health by avoiding calling emergency services or denying transport from an accident scene. These risks are especially true in lower-income communities where large bills seem impossible to overcome.
To address this problem, on October 3, 2023, Governor Newsom signed Assembly Bill 716 which goes into effect on January 1, 2024. This new law prevents surprise bills from ground ambulance rides for Californians and limits how much Californians will have to pay. It closes a major loophole that left patients on the hook for out-of-network ambulance bills. When you call 911 or are transported from an accident scene, you cannot control what ambulance company will transport you. You cannot request an “in-network” ambulance ride. This new law requires a health insurance policy or health care service plan to pay no more than the same cost-sharing amount the insured would pay for the same covered service received from a contracting ground ambulance provider. Uninsured patients are also protected from inflated ambulance costs and will be charged Medi-Cal or Medicare rates, whichever is higher.
In addition to protecting Californians from inflated ambulance costs, the new law also gives people more time to address their ambulance bills. It protects consumers from having their credit adversely affected for 12 months. The law states a non-contracting ground ambulance provider shall not report adverse information to a consumer credit reporting agency or start a civil action for an unpaid ambulance bill for a minimum of 12 months after the initial billing. After twelve months, the ambulance provider can only send to collections the amount allowed under the new law, not the out-of-network amount.
When the new law goes into effect on January 1, 2024, Californians will not have to be afraid of being surprised by out-of-network ambulance bills. Californians will have more financial security during and after a medical emergency. If you need emergency services, do not hesitate to call 911. If you are experiencing a surprise ambulance bill, contact the Health Consumer Alliance at 888-804-3536.