North Dakota law limits bills for ground ambulance care

Licensed ambulance providers may not bill covered people more than the cost sharing they would owe for in-network ambulance care. It applies to licensed basic and advanced life support ambulance services and limits bills to the person's in-network deductible, coinsurance, copayment, or other cost sharing. The limit does not apply to air ambulance providers.

Health insurers must pay ambulance reimbursements directly to the provider or someone the provider chooses. It covers reimbursements for ambulance services provided to a person covered by a health benefit plan.

For out-of-network ambulance services, health insurers must pay the lower of 250 percent of the local Medicare rate for the same service or the provider's billed charge. It applies to medically necessary ambulance care or transportation from a licensed basic or advanced life support provider outside the plan's network. Air ambulance providers are excluded. The insurer's payment does not have to include the covered person's deductible, copayment, or coinsurance, whether owed or already paid.

The Legislative Management must consider studying whether grants for ambulance providers' unpaid bills are feasible and desirable, then report its findings and recommendations to the next Assembly. The possible study concerns a grant system to reimburse ambulance providers for unpaid bills. If the study is conducted, it must include input from stakeholders, including the Insurance Department, and a survey of ambulance providers. Up to $20,000 from the general fund is set aside for consulting services for the study. The study consideration is for the 2025–26 interim. The report goes to the seventieth Legislative Assembly.