All Roll Calls
Yes: 269 • No: 7
North DakotaHB 13222025 Regular SessionHouseWALLET
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.
Sponsored By: Robin Weisz (Republican)
Signed by Governor
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
Patients protected from extra ambulance bills
For covered ambulance services, providers cannot charge you more than your health plan's in-network share. This includes your deductible, copay, coinsurance, and other required cost sharing. The protection covers North Dakota-licensed basic and advanced life support ambulance services. Air ambulance providers are excluded.
Ambulance crews get updated communication rules
The department can regulate the main communication methods and procedures used by emergency medical services. Its rules must match protocols set by the North Dakota Department of Emergency Services. Crews can also use backup communication devices, including cell phones.
State funds unpaid ambulance bill study
Legislative Management must study a possible grant system to reimburse ambulance providers for overdue bills during the 2025–26 interim. The study must survey ambulance providers and seek stakeholder input, including from the insurance department. Findings, recommendations, and any needed legislation go to the Seventieth Legislative Assembly. The Legislative Council receives $20,000 in one-time general fund money for study consultants from July 1, 2025, through June 30, 2027. The law funds the study, not a grant program or patient debt relief.
Direct ambulance payments with rate limits
North Dakota-regulated health insurers must pay providers or their chosen recipients directly for covered, medically necessary ambulance care or transportation. For out-of-network services, insurers pay the lower of 250% of Medicare's local rate for the same service or billed charges. That insurer payment rate cannot be required to include the patient's deductible, copay, or coinsurance, owed or already paid. These rules cover North Dakota-licensed basic and advanced life support ambulance services, not air ambulances. The insurance commissioner can issue rules to carry out and enforce these requirements.
Sponsors & Cosponsors
Sponsor
Robin Weisz
Republican • House
Cosponsors
Kristin Roers
Republican • Senate
Roll Call Votes
Senate vote • 4/23/2025
Second reading, passed as amended, yeas 47 nays 0
Yes: 47 • No: 0
House vote • 4/22/2025
Second reading, passed, yeas 89 nays 4
Yes: 89 • No: 4
Senate vote • 4/3/2025
Second reading, passed as amended, yeas 46 nays 1
Yes: 46 • No: 1
House vote • 2/25/2025
Second reading, passed, yeas 87 nays 2
Yes: 87 • No: 2
Actions Timeline
Filed with Secretary Of State 04/28
4/30/2025HouseSigned by Governor 04/28
4/29/2025HouseSent to Governor
4/25/2025HouseSigned by Speaker
4/25/2025HouseSigned by President
4/24/2025SenateSecond reading, passed as amended, yeas 47 nays 0
4/23/2025SenateConference committee report adopted
4/23/2025SenateReported back from conference committee, in place of, placed on calendar
4/23/2025SenateSecond reading, passed, yeas 89 nays 4
4/22/2025HouseConference committee report adopted
4/22/2025HouseReported back from conference committee, in place of, placed on calendar
4/17/2025HouseConference committee appointed Weston Roers Van Oosting
4/14/2025SenateConference committee appointed Fegley Kiefert Rios
4/10/2025HouseRefused to concur
4/10/2025HouseReturned to House (12)
4/4/2025HouseSecond reading, passed as amended, yeas 46 nays 1
4/3/2025SenateAmendment adopted, placed on calendar
4/3/2025SenateReported back amended, do pass, amendment placed on calendar 5 0 1
4/2/2025SenateCommittee Hearing 10:06
4/1/2025SenateCommittee Hearing 09:30
3/11/2025SenateIntroduced, first reading, referred Human Services Committee
3/7/2025SenateReceived from House
2/25/2025SenateSecond reading, passed, yeas 87 nays 2
2/25/2025HouseAmendment adopted, placed on calendar
2/25/2025HouseReported back amended, do pass, amendment placed on calendar 12 0 1
2/24/2025House
Bill Text
Adopted by the Conference Committee
Adopted by the House Human Services Committee
Enrollment
FIRST ENGROSSMENT
FIRST ENGROSSMENT with Conference Committee Amendments
FIRST ENGROSSMENT with Senate Amendments
INTRODUCED
Prepared by the Legislative Council staff for Senator Roers
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