HB 1322 — AN ACT to create and enact a new section to chapter 23-27 and a new section to chapter 26.1-47 of the North Dakota Century Code, relating to ambulance service balanced billing and provider reimbursement; to amend and reenact section 23-27-04.8 of the North Dakota Century Code, relating to emergency medical services communication; to provide for a legislative management study; and to provide an appropriation.

25.0744.03000 Sixty-ninth Legislative Assembly of North Dakota FIRSTIn ENGROSSMENTRegular ENGROSSEDSession Commencing Tuesday, January 7, 2025 HOUSE BILL NO.

1322 Introduced(Representative byWeisz) Representative(Senator WeiszRoers) SenatorAN RoersACT Ato BILLcreate forand anenact Acta new section to createchapter 23-27 and enact a new chaptersection to titlechapter 2326.1-47 of the North Dakota Century Code, relating to ambulance service balanced billing and provider reimbursement;

The department shall use pagers or third-party vendors and cell phones as a communication method and may regulate the primary communications methods and protocols for emergency medical services operations in a mannermannerwhile consistentpermitting withsecondary thecommunications protocolsthrough establishedother bydevices, theincluding departmentcell ofphones. emergency services.

The regulations must be consistent with the protocols established by the department of emergency services.

A new chaptersection to titlechapter 2323-27 of the North Dakota Century Code is created and enacted as follows:

Definitions.Balance billing prohibited - Enforcement.

"AmbulanceFor purposes of this section, "ambulance service provider" means a service entity licensed under chapter 23-27 as a basic life support or advanced life support ambulance service.

"BalanceAn bill" means the amount an ambulance service provider may chargenot and collect fromor abill coveredmore individualthan for the provisioncovered ofindividual's ambulancedeductible, services,coinsurance, equalingcopayment, theor differenceother betweencost-sharing amount the amountcovered paidindividual bywould thebe healthresponsible carefor insurerif andservices thewere amountprovided theby a participating ambulance service providerprovider. billed.

PageSECTION No.3.

1A 25.0744.03000new Sixty-ninthsection Legislativeto Assemblychapter 3.26.1-47 of the North Dakota Century Code is created and enacted as follows:

Ambulance insurance coverage - Direct payment required - Determination of reimbursement rate for out-of-network ambulance service providers.

1.

As used in this section:

a.

"Ambulance service provider" means a service entity licensed under chapter 23-27 as a basic life support or advanced life support ambulance service.

The term does not include an air ambulance provider.

b.

4.c.

5.H.

B.

NO.

1322 - PAGE 2 d.

a.(1) An insurance company;

An(2) insuranceA company;health maintenance organization;

b.(3) A hospital or medical service corporation;

and (4) A healthrisk-based maintenanceprovider organization;organization.

c.e.

A"Medicare hospitalreimbursement orrate" medicalmeans the reimbursement rate for a particular health care service corporation;provided under the Health Insurance for the Aged and Disabled Act, title XVIII of the federal Social Security Act of 1965 [42 U.S.C.

and d.

A risk-based provider organization.

6.

"Medicare reimbursement rate" means the reimbursement rate for a particular health care service provided under the Health Insurance for the Aged and Disabled Act, title XVII of the federal Social Security Act of 1965 [42 U.S.C.

Direct payment required - Determination of reimbursement rate for out-of-network ambulance service providers.

1.

All reimbursements made by a health care insurer for the provision of ambulance services to a covered individual must be paid directly to the ambulance service provider or the provider's designee.

All reimbursements made by a health care insurer for the provision of ambulance services to a covered person must be paid directly to the ambulance service provider or the provider's designee.

3.

3.4.

Balance5. billing prohibited - Enforcement.

1.