By EMS1 staff
COLUMBUS, Ohio — Efforts to protect Americans from costly, unexpected ambulance bills are proving complex, with a new study from the Ohio State University revealing that New York’s attempt to regulate these charges resulted in a 13% price increase.
The research, led by Wendy Xu of Ohio State’s College of Public Health, examined the impact of a 2015 New York law designed to prevent “balance billing” by out-of-network ambulance services. Although the law shields patients from having to cover the full cost of emergency ground ambulance services, it has led to increased rates charged by providers, likely contributing to higher health insurance premiums, according to Xu’s findings, published in Health Services Research.
While the federal “No Surprises Act,” enacted in 2022, addresses out-of-network medical bills for services such as air ambulances, it does not cover ground ambulance bills. This leaves many Americans vulnerable to significant costs following emergency services where they cannot choose which provider responds.
“People often need these ambulances for life-threatening emergencies, and patients and their families aren’t in a position to choose which ambulance will be sent based on their insurance coverage,” said Xu. “If the closest ambulance saves your life but is out of network, you might find that you’re being asked to pay the whole bill even if you have insurance.”
New York’s law mandates that insurance companies pay “usual, customary and reasonable rates” to ambulance providers. However, Xu’s analysis of national claims data shows that ambulance providers raised their prices in response to the law, contributing to a 13% overall cost increase in the state compared to others without such regulations.
Xu warned that these price hikes are likely to lead to increased healthcare premiums. The study underscores the difficulty in regulating ground ambulance services, which are run by both private companies and government agencies, each with different pricing structures. While some states are passing similar laws, Xu’s research suggests these measures may inadvertently drive up costs rather than reduce them.
Despite a federal committee’s recommendations to tackle this issue, no nationwide action has been taken yet.
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