Surprise medical bills, often resulting from out-of-network care, are a nationwide concern. Since 2022, the No Surprises Act (NSA) has protected patients from unexpected medical costs incurred at hospitals, by healthcare providers, and by air ambulances.
Though ground ambulance providers were largely exempt from the initial federal protections, the Act introduced new considerations for the EMS industry. The No Surprises Act requires healthcare providers to offer patients clear, upfront information about their rights related to surprise medical billing. Providers must inform patients if a service might result in out-of-network charges and supply a “Good Faith Estimate” for out-of-pocket costs in non-emergency situations. For emergency services, patients cannot be charged more than in-network rates and should receive detailed notices about their right to dispute billing inaccuracies.
With these requirements, EMS providers now face heightened obligations to maintain transparency, particularly in patient communications. The Act’s emphasis on clear information and billing expectations means EMS agencies must proactively ensure compliance while minimizing surprise billing risks.
Expanding the No Surprises Act In Texas
The State of Texas has taken additional measures to expand the No Surprises Act. On January 1, 2024, Senate Bill 2476 went into effect, applying to emergency medical services provided on or after that date. SB 2476 eliminates balance billing for out-of-network patients for all ground ambulance services, aiming to enhance consumer protections against surprise billing.
At EMERGICON, we support EMS agencies in navigating the complex requirements of the NSA and SB 2476, streamlining patient communications, and helping ensure regulatory compliance. For questions about surprise billing, contact EMERGICON through our EMS & Client Hotline: 866-839-3671 | support@emergicon.com.