Last year, Jennifer Reisz's college-age daughter, Megan, was kicked in the chest multiple times by the family's horse. Megan fell to the ground, unable to move or speak. Though she was alone, her Apple Watch detected her distress and called 911.
She was taken to a hospital in Clovis, a city in Fresno County, near where the Reisz family lives. But the severity of Megan's injuries — four broken ribs and a partially collapsed lung — prompted doctors to transport her 12 miles by ambulance to the Level I trauma center at Community Regional Medical Center in Fresno.
At the federal level, an advisory committee established under the No Surprises Act is working on a plan to address the problem nationally. The new law, which applies to about 14 million Californians enrolled in state-regulated commercial health plans, limits how much a non-network ambulance operator can charge patients to the amount they would pay for an in-network ambulance.
The advisory committee working on a federal fix agreed last week on nonbinding proposals that would, among other things, prohibit balance billing for the vast majority of ambulance rides and cap patients' financial liability at $100. The committee plans to formally report its recommendations to Congress early next year for potential legislation.
But local authorities might be tempted to hike ambulance rates over time to increase revenue for publicly run ambulance operators, such as fire departments, says Loren Adler, associate director of the Brookings Schaeffer Initiative on Health Policy. That could prompt health plans to raise ambulance copays, offsetting some of the consumer savings from the new law, Adler says.
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