North Carolina H489 establishes minimum reimbursement rates for emergency ambulance services by out-of-network providers.
North Carolina H489 mandates that insurers cover emergency services, including those provided by out-of-network ambulance service providers. It sets a minimum allowable reimbursement rate for these services, which is either 100% of the rate set by a local governmental entity or 400% of the most recent published Medicare rate for the same services in the same geographic area. Insurers must promptly remit payment directly to the ambulance service provider and cannot impose cost-sharing requirements exceeding $100 or 10% of the minimum allowable reimbursement rate.
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- Core Provisions
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- Legal Framework
- Critical Issues
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