UtahH.B. 2692026 General SessionHouseWALLET

Ambulance Provider Payment Amendments

Sponsored By: A. Cory Maloy (Republican)

Signed by Governor

Health and Human ServicesHealth Care ProfessionalsLegislative OperationsAdministrative RulemakingAdministrative Rulemaking and ProceduresSunsets and RepealersNew Rulemaking AuthorityEmergency Medical Services

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 2 benefits, 1 costs, 1 mixed.

Patients can owe unpaid ambulance charges

Beginning July 1, 2026, an ambulance provider can bill patients when their insurance does not allow the full base and mileage rates. The bill can equal those rates minus what the health plan or another third party actually paid. Outside the stated exceptions, providers generally cannot bill insured patients for the difference between their charges and the plan's allowed amount. Providers can also bill uninsured patients and charge for services the plan denies as not covered.

New base charges for ambulance patients

Beginning July 1, 2026, ground ambulance base rates per ride are $1,257.15 for emergency medical technician transport, $1,659.66 for advanced technician transport, and $2,426.64 for paramedic transport. These rates include supplies, procedures, and medication up to the medication cost cap; mileage costs extra, with annual rates and a maximum set by the Bureau of Emergency Medical Services. Technician and advanced technician rides qualify for the $2,426.64 rate only when a designated dispatch center sends a licensed paramedic, the paramedic starts advanced life support, medical control directs the paramedic to stay during transport, and the ambulance provider has a payment agreement with the paramedic provider. Beginning July 1, 2027, the bureau must publish adjusted rates by July 1 each year, multiplying the current rate by the medical care price index—the unadjusted 12-month medical services rate published each December by the U.S. Bureau of Labor Statistics. Rates can change only once per calendar year, and decreases require an express bureau rule.

Health plans must pay ambulances directly

Beginning July 1, 2026, health plans must accept correctly charged ground ambulance base rates and bureau-set mileage rates as allowed expenses. Employers or their workers' compensation carriers must also accept these charges for covered ambulance claims. Medication costs are included in the base rate rather than treated as a separate allowed expense. Health plans must pay ambulance providers directly, even when the provider is out of network. The law also removes scheduled July 1, 2027 repeals for health plan payments, workers' compensation payments, and maximum ambulance rates.

Higher Medicaid payments for ambulance services

Beginning July 1, 2026, Utah must pay the highest rate allowed by the assessment for covered fee-for-service Medicaid ambulance services. This payment requirement starts only after the Centers for Medicare and Medicaid Services approves the assessment. The change raises provider reimbursement, not a cash benefit paid to Medicaid members.

Sponsors & Cosponsors

Sponsor

A. Cory Maloy
Republican • House

Cosponsors

Evan J. Vickers
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 209 • No: 2

Senate vote • 3/5/2026

Senate/ substituted

Yes: 0 • No: 0

House vote • 3/5/2026

House/ concurs with Senate amendment

Yes: 66 • No: 1

Senate vote • 3/5/2026

Senate/ passed 2nd & 3rd readings/ suspension

Yes: 26 • No: 0

Senate vote • 2/25/2026

Senate/ passed 2nd reading

Yes: 24 • No: 0

Senate vote • 2/19/2026

Senate Comm - Favorable Recommendation

Yes: 4 • No: 0

House vote • 2/13/2026

House/ passed 3rd reading

Yes: 67 • No: 1

House vote • 2/4/2026

House Comm - Substitute Recommendation

Yes: 11 • No: 0