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Surprise ambulance bills put these families in debt. A new California law bans the practice (calmatters.org)

submitted 10 months ago by [email protected] to c/[email protected]

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The COVID-19 pandemic took a brutal toll on Danielle Miele’s family, but after two exorbitant ambulance bills she’s afraid to call 911.

Her teenage son attempted suicide in 2022, Miele said. His mental health deteriorated during the pandemic, and he needed an ambulance transfer from the Roseville emergency room where Miele took him to a treatment center in San Mateo. The ambulance company hit Miele with a $9,000 out-of-network charge, which was sent to collections “almost immediately,” she said.

The virus also left Miele with seizures that mimic the symptoms of a heart attack, she said. Miele called 911 the first time a seizure happened. The 15-minute ride to the hospital cost $4,000 without help from insurance.

…

A new California law taking effect Jan. 1 targets the kind of “surprise” ambulance bills that put Miele’s family in debt even though they had medical insurance. These bills take the form of out-of-network charges for commercially insured patients who have no control over which ambulance company responds to a call for help.

Under the new law, patients will only have to pay the equivalent of what they would have paid for an in-network service. Health insurance and ambulance companies will have to settle the bill directly even if they don’t have an existing contract.

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[–] [email protected] 17 points 10 months ago (1 children)

Yeah, they provide a ton of transport services that are not emergency-related. If a person is completely bedbound, then any and all trips to the doctor need to be handled by an ambulance service that can provide a transport stretcher (a heavy duty collapsible stretcher with straps on it like a seatbelt) and personnel to transfer the person between their bed and the stretcher.

And we call the ambulance service when we discharge any patient from our hospital to a short term rehab facility, even if the person can move themselves from the bed to the stretcher. Just because it's transfer between medical facilities.

And if we transfer someone to another hospital with a higher level of care, we have to specifically request an emergency ambulance instead of a transport ambulance.

So those services are a lot more complicated than people realize. But in any of these situations, the patient shouldn't get an exorbitant bill because of some insurance company shenanigans, which is all in- vs. out-network stuff is.

[–] [email protected] 7 points 10 months ago

It’s bizarre because they solved this with ERs/hospitals forever ago - there used to be in network and out of network ERs/hospitals. Even worse, even if the hospital was in-network, some of the Drs working in the hospital would be out of network - so your surgeon would be in network but the anesthesiologist wouldn’t be somehow.

I don’t know why it’s taken them so long to solve ambulances too.

When you don’t have a choice in providers, it seems bizarre they can pull the in/out of network shit.