House Bill 1850 / Act 867 and House Bill 1863 / Act 836 - Specific Effects on EMS Providers Related to Reimbursement

Please see the effect, impact, and provider responsibility of each law detailed below.

HB 1850 / Act 867

Effect  - “The minimum allowable reimbursement rate under any health benefit plan issued by a healthcare insurer to a participating ground ambulance service provider or an out-of-network ground ambulance service provider shall be at the rates approved or contracted between the ambulance service provider and the local government entity as provided for in § 14-266-105.

On and after July 1, 2025, in the absence of rates set as provided under subdivision (a)(1) of this section, the minimum allowable rate of reimbursement under a health benefit plan issued by a healthcare insurer shall be the lesser of:

 (A) Three hundred twenty-five percent (325%) of the Medicare Ambulance Fee Schedule, Arkansas Rural Rate, as established by the Centers for Medicare & Medicaid Services at the time of the date of service for the same service provided; or

(B) The provider's billed charges.”

Impact - One of three things will occur specific to your reimbursement.

1)     if you operate in a city, county, municipality, or region that has adopted a fee schedule for Ambulance services, the Commercial Insurer must pay you the adopted fee schedule.

2)     If you operate in a city, county, or region that has not adopted a fee schedule for Ambulance Services, the Commercial Insurer must pay you the LESSOR of:

a.      Three hundred twenty-five percent (325%) of the Medicare Ambulance Fee Schedule, Arkansas Rural Rate

OR

b.     Your service’s billed charges

Commercial Insurers, regardless of whether you are in or out of network, are required to pay your service as detailed above.

What do I need to do now?

Provider Responsibilities - For dates of service after July 1, 2025, confirm that Commercial Insurers are reimbursing your service in compliance with House Bill 1850 / Act 867.

House Bill 1863 / Act 836

Effect - “Arkansas Code § 23-99-1706, concerning enforcement and rules of the Transportation Benefit Manager Act, is amended to add an additional subsection to read as follows: (d)(1) On and after July 1, 2025, the Arkansas Ambulance Association shall collect the rates that are approved or contracted for between an ambulance provider and a local government entity as provided for under § 14- 16 266-105.

The information required under subdivision (d)(1) of this section shall be submitted annually to the commissioner.”

Impact - By July 1, 2025 the Arkansas Ambulance Association is now required by law to provide to the Commissioner of the Arkansas Department of Insurance a listing of all cities, counties, municipalities, or regions that have adopted and Ambulance Fee Schedule.

Provider Responsibilities - Complete the locally approved or contracted rate survey distributed by the Arkansas Ambulance Association on or before June 27, 2025. 

To prepare to complete the survey, if you operate in an area with a locally mandated rate, you will need the following information:

•       The name of the mandating entity (city, town, county, etc)

•        The date rate schedule was formally adopted (month and year)

•        The adopted rates for the following codes A0382, A0398, A0425, A0427, A0429 A0433, A0434, A0426, A0428, G2021, and G2022

If you do not have a locally approved or contracted rates, there will be an option to provide that information on the survey.  

Access the survey here: Service Rate Survey 

If you have different rates for different service areas, please submit another survey using the same link (survey link). 

The Arkansas State Legislature has mandated by law that this data be collected and submitted to the Arkansas Commission of Insurance. Your time and attention to ensure compliance and are very much appreciated.

Arkansas State Legislature 

Arkansas Congress Members