Bill would bar advance approval for some emergency medical care

Insurance reviewers could not demand advance approval for these ambulance services. It covers ambulance services for insured patients when the provider is outside their plan's network. The service must be given within 12 hours after it is requested; the rule would take effect July 1, 2026.

Insurance reviewers could not demand advance approval for these emergency or urgent responses. It covers emergency crews' medical assessment and treatment for insured patients and trips to, from, or between hospitals or health facilities when care is needed to prevent serious harm, protect health, or avoid delays. Crews must act in good faith, meaning they make an honest effort to respond. Care must be given within 24 hours after it is requested; the rule would take effect July 1, 2026.

Plans that cover emergency medical services would pay qualifying emergency care providers for covered responses. This applies to certain health insurance policies and individual or group health maintenance organization contracts that cover emergency medical services. Providers must be certified as advanced life support groups and work within their permitted duties. Qualifying care includes responses to calls or texts for help, care through a mobile health program, or care a doctor says is needed. The patient does not have to be taken to a hospital. The payment provisions would take effect July 1, 2026.