UtahH.B. 3012025 General SessionHouseWALLET

Ambulance Provider Payment Amendments

Sponsored By: A. Cory Maloy (Republican)

Signed by Governor

Health InsuranceInsuranceInsurance DepartmentWorkers' CompensationBusinessHealth and Human ServicesHealth CareHealth Care ProfessionalsDepartment of Public SafetySunsets and RepealersPharmaceuticalsEmergency Medical Services

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Ambulance patients gain surprise bill protections

Beginning May 7, 2025, Utah bans ground ambulance and paramedic providers from billing patients above their health plan’s allowed amount for covered services. This ban excludes uninsured patients, amounts the plan allowed but did not pay, and services denied as uncovered. Health plans, employers, and employers’ workers’ compensation insurers must accept correctly charged base rates, mileage, and provided medicines as allowable expenses. They must pay qualifying ambulance claims directly to providers, including out-of-network providers. These billing and payment rules end July 1, 2027.

Limits on patients’ ground ambulance charges

Beginning May 7, 2025, Utah caps ground ambulance base charges per trip: EMT $1,234.92, advanced EMT $1,630.31, and paramedic $2,383.73. The base charge covers transport to a hospital or receiving facility, supplies, procedures, and giving medicines—not mileage or medicine purchases. Medicine charges cannot exceed the lower of national average drug acquisition cost and Utah Medicaid’s maximum allowable cost. Mileage rates and total mileage charges are capped through state rules. An EMT or advanced EMT trip can use the paramedic rate only when all four requirements apply: a designated emergency medical service dispatch center sends the ambulance; a licensed paramedic provider starts advanced life support; online medical control directs the paramedic to stay during transport; and the ambulance and paramedic providers have a payment agreement. The restrictions do not apply in designated service areas that include a town under Utah law. The law prioritizes a legislative audit of ambulance provider, paramedic, and insurer rates and payments. These rate provisions end July 1, 2027.

Sponsors & Cosponsors

Sponsor

A. Cory Maloy
Republican • House

Cosponsors

Evan J. Vickers
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 116 • No: 0

Senate vote • 3/6/2025

Senate/ passed 2nd & 3rd readings/ suspension

Yes: 26 • No: 0

Senate vote • 2/26/2025

Senate Comm - Favorable Recommendation

Yes: 2 • No: 0

House vote • 2/21/2025

House/ substituted

Yes: 0 • No: 0

House vote • 2/21/2025

House/ passed 3rd reading

Yes: 66 • No: 0

House vote • 2/13/2025

House Comm - Substitute Recommendation

Yes: 11 • No: 0

House vote • 2/13/2025

House Comm - Favorable Recommendation