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.
Be on the lookout for a rate survey distributed by the ArAA in the upcoming week. Please complete this survey for each service area.
