# Alabama SB269: Ground ambulance services; to prohibit balance billing and set minimum reimbursement rates by health care insurers to emergency medical service providers Alabama SB269, Ground ambulance services; to prohibit balance billing and set minimum reimbursement rates by health care insurers to emergency medical service providers, is a 2026 Regular Session Senate bill sponsored by Bobby D. Singleton (Democratic); status enacted, last action 2026-04-06 (Enacted); PRIA reads it as touching household money (as of 2026-10-16). - Canonical: https://policyrisk.com/state-bill/AL-SB269-2026rs - As of: 2026-10-16 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Alabama SB269 - State: Alabama - Session: 2026 Regular Session - Title: Ground ambulance services; to prohibit balance billing and set minimum reimbursement rates by health care insurers to emergency medical service providers - Status: enacted - Chamber: Senate - Introduced: 2026-02-05 - Last action: 2026-04-06, Enacted - Sponsor: Bobby D. Singleton (Democratic) - Cosponsors: 0 - Subjects: Insurance - Touches household money: yes - Roll calls: 5 (282 yes, 5 no in all) - Economic provisions PRIA read: 4 ## Summary No summary available. ## Bill overview: provisions PRIA read - Patients get protection from extra ambulance bills: benefit, high. Beginning October 1, 2026, covered ambulance services cannot cost you more than your plan’s in-network cost-sharing amount. This applies to plans subject to this law, whether the provider is in or out of network. Payments under the law count as payment in full; providers and their billing agents ca… - Insurers must pay ambulance providers promptly: benefit, low. Beginning October 1, 2026, insurers must pay out-of-network ambulance providers directly, not send payments to patients. For covered services, complete electronic claims require payment within 30 days; complete written claims require payment within 45 days. For incomplete claims, insurers must ackn… - Three insurers fund ambulance cost study: cost, low. The Alabama Association of Ambulance Services must hire a regional business school to study the law’s effects on ambulance services and costs. The school must award doctoral degrees and hold accreditation from the Association to Advance Collegiate Schools of Business. The study must compare other s… - Higher ambulance payments with billing limits: mixed, low. Beginning October 1, 2026, insurers must pay in-network providers at least 200% of Medicare’s rate for covered emergency ground transports. Beginning January 1, 2027, in-network treatment without transport has a 200% minimum based on Medicare’s basic-life-support rate. Out-of-network emergency grou… ## Sponsors and cosponsors - Sponsor: Bobby D. Singleton (Democratic), Senate ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2026-03-31 | House | Third Reading in Second House | pass | 102 | 0 | 1 | | 2026-03-31 | House | Motion to Read a Third Time and Pass - Adopted Roll Call 1066 | pass | 103 | 0 | 1 | | 2026-03-03 | Senate | Singleton motion to Adopt - Adopted Roll Call 682 | pass | 25 | 1 | 1 | | 2026-03-03 | Senate | Third Reading in House of Origin | pass | 25 | 2 | 1 | | 2026-03-03 | Senate | Motion to Read a Third Time and Pass as Amended - Adopted Roll Call 683 | pass | 27 | 2 | 1 | ## Actions (21) - 2026-04-06: Enacted (Senate) - 2026-03-31: Third Reading in Second House (House) - 2026-03-31: Motion to Read a Third Time and Pass - Adopted Roll Call 1066 (House) - 2026-03-31: Ready to Enroll (Senate) - 2026-03-31: Enrolled (Senate) - 2026-03-31: Signature Requested (House) - 2026-03-31: Delivered to Governor (Senate) - 2026-03-17: Reported Out of Committee Second House (House) - 2026-03-17: Read for the Second Time and placed on the Calendar (House) - 2026-03-05: Read for the first time and referred to the House Committee on Insurance (House) - 2026-03-05: Pending Committee Action in Second House (House) - 2026-03-03: Third Reading in House of Origin (Senate) - 2026-03-03: Banking and Insurance 1st Substitute Offered (Senate) - 2026-03-03: Singleton motion to Adopt - Adopted Roll Call 682 (Senate) - 2026-03-03: Motion to Read a Third Time and Pass as Amended - Adopted Roll Call 683 (Senate) - 2026-03-03: Engrossed (Senate) - 2026-02-26: Banking and Insurance 1st Substitute (Senate) - 2026-02-26: Reported Out of Committee House of Origin (Senate) - 2026-02-26: Read for the Second Time and placed on the Calendar (Senate) - 2026-02-05: Read for the first time and referred to the Senate Committee on Banking and Insurance (Senate) - 2026-02-05: Pending Committee Action in House of Origin (Senate) ## Bill text - As Introduced: [PDF](https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2026RS/SB269-int.pdf) - Engrossed: [PDF](https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2026RS/SB269-eng.pdf) - Enrolled: [PDF](https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2026RS/SB269-enr.pdf) ## Related bills - HB67: Voter Information; limit cost of reproducing voter registration list; crime for misuse of personal voter information; created (enacted) - SB154: State employees, cost-of-living increase for fiscal year beginning October 1, 2026 (enacted) - SB165: Elections; municipal elections, to set qualification fee amounts, to require indigent candidates to submit documentation for fee exemption (enacted) - HB317: Firefighter distinctive license plate; fire chaplains included, penalty for violations provided for (enacted) - SB272: Open Records; use of public records relating to schools for certain solicitation purposes prohibited; redaction of certain information relating to financial tr… (enacted) - SB190: Sales Tax; to exempt Precision Ocular (enacted) ## Sources - [As Introduced (PDF)](https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2026RS/SB269-int.pdf) - [Engrossed (PDF)](https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2026RS/SB269-eng.pdf) - [Enrolled (PDF)](https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2026RS/SB269-enr.pdf) ## Related - [HB67: Voter Information; limit cost of reproducing voter registration list; crime for…](https://policyrisk.com/state-bill/AL-HB67-2026rs) - [SB154: State employees, cost-of-living increase for fiscal year beginning October 1, 2…](https://policyrisk.com/state-bill/AL-SB154-2026rs) - [SB165: Elections; municipal elections, to set qualification fee amounts, to require in…](https://policyrisk.com/state-bill/AL-SB165-2026rs) - [HB317: Firefighter distinctive license plate; fire chaplains included, penalty for vio…](https://policyrisk.com/state-bill/AL-HB317-2026rs) - [SB272: Open Records; use of public records relating to schools for certain solicitatio…](https://policyrisk.com/state-bill/AL-SB272-2026rs) - [SB190: Sales Tax; to exempt Precision Ocular](https://policyrisk.com/state-bill/AL-SB190-2026rs) - [Alabama bills](https://policyrisk.com/states/alabama/bills) - [Alabama state hub](https://policyrisk.com/states/alabama) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/AL-SB269-2026rs (as of 2026-10-16).