Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 301 (2025GS)

Sponsor

Rep. Maloy, A. Cory

Final action

Governor Signed 3/25/2025

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• defines terms;
• codifies a base rate for ground ambulance transports;
• prohibits a ground ambulance provider from charging rates that exceed established rates;
• prohibits balance billing;
• requires an insurer and workers' compensation to allow for established rates;
• requires the Office of the Legislative Auditor General to conduct an audit if prioritized; and
• creates a repeal date.

Every vote on this bill

Bill text

11
31A-22-627.1
34A-2-407.1
53-2d-503
63I-1-231
63I-1-234
63I-1-253
0
Ambulance Provider Payment Amendments
2025 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: A. Cory Maloy
Senate Sponsor: Evan J. Vickers
LONG TITLE
General Description:
This bill amends provisions related to ambulance billing and charges.
Highlighted Provisions:
This bill:
defines terms;
codifies a base rate for ground ambulance transports;
prohibits a ground ambulance provider from charging rates that exceed established rates;
prohibits balance billing;
requires an insurer and workers' compensation to allow for established rates;
requires the Office of the Legislative Auditor General to conduct an audit if prioritized; 
and
creates a repeal date.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
53-2d-503
, as last amended by Laws of Utah 2024, Chapter 240
63I-1-231
, as last amended by Laws of Utah 2023, Chapter 28
63I-1-234
, as last amended by Laws of Utah 2024, Third Special Session, Chapter 5
63I-1-253
, as last amended by Laws of Utah 2024, Third Special Session, Chapter 5
ENACTS:
31A-22-627.1
, Utah Code Annotated 1953
34A-2-407.1
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1, Section 
31A-22-627.1
 is enacted to read:
31A-22-627.1
. Ground ambulance reimbursement.
(1)
As used in this section:
(a)
"Base rate" means the same as that term is defined in Section 
53-2d-503
.
(b)
"Medication maximum cost" means the same as that term is defined in Section 
53-2d-503
.
(2)
For a mileage rate established in a rule created under Section 
53-2d-503
, a health benefit 
plan shall accept a correctly charged mileage rate as an allowable expense for a claim.
(3)
For claims made under Section 
53-2d-503
, a health benefit plan shall accept a correctly 
charged amount:
(a)
that is equal to the base rate as an allowable expense; and
(b)
that is equal to the medication maximum cost as an allowable expense for a provided 
medication.
(4)
A health benefit plan shall make a payment for claims described in this section directly 
to the provider, including an out-of-network provider.
Section 2, Section 
34A-2-407.1
 is enacted to read:
34A-2-407.1
. Ground ambulance reimbursement.
(1)
As used in this section:
(a)
"Base rate" means the same as that term is defined in Section 
53-2d-503
.
(b)
"Medication maximum cost" means the same as that term is defined in Section 
53-2d-503
.
(2)
For a mileage rate established in a rule created under Section 
53-2d-503
, an employer or 
the employer's workers' compensation insurance carrier, if any, shall accept a correctly 
charged mileage rate as an allowable expense for a claim.
(3)
For claims made under Section 
53-2d-503
, an employer or the employer's workers' 
compensation insurance carrier, if any, shall accept a correctly charged amount:
(a)
that is equal to the base rate as an allowable expense; and
(b)
that is equal to the medication maximum cost as an allowable expense for a provided 
medication.
(4)
An employer or the employer's workers' compensation insurance carrier, if any, shall 
make a payment for claims described in this section directly to the provider, including 
an out-of-network provider.
Section 3, Section 
53-2d-503
 is amended to read:
53-2d-503
. Establishment of maximum rates.
(1)
The
As used in this section:
(a)
(i)
"Balance bill" means the practice of a health care provider billing an individual 
for the difference between the individual's billed charges and the amount the 
individual's health benefit plan allows for a covered service.
(ii)
"Balance bill" does not include billing:
(A)
an uninsured individual for services provided;
(B)
an individual for the difference of the amount allowed by a health benefit plan 
for a billed service and the amount paid by the health benefit plan for the billed 
service; and
(C)
an individual for a service that was denied by the health benefit plan because 
the service was an uncovered service under the health benefit plan.
(b)
(i)
"Base rate" means the rate a ground ambulance provider charges for:
(A)
transporting an individual to a hospital or patient receiving facility;
(B)
supplies used when transporting the individual;
(C)
providing procedures during transport; and
(D)
administering medications during transport.
(ii)
"Base rate" does not include charges for:
(A)
the cost of a medication; or
(B)
mileage.
(c)
"Medication maximum cost" means a cost for a medication that equals the lower of 
the:
(i)
national average drug acquisition cost; and
(ii)
Utah maximum allowable cost established in the Utah Medicaid program.
(2)
 bureau shall, after receiving recommendations under Subsection (2), establish 
maximum rates for ground ambulance providers and paramedic providers that are just 
and reasonable
The bureau shall establish a maximum mileage rate for ground 
ambulance providers and paramedic providers that is just and reasonable
.
(2)
(3)
The committee may make recommendations to the bureau on the maximum 
rates 
that should be
mileage rate
 set under Subsection 
(1)
(2)
.
(3)
(4)
(a)
Ground ambulance providers and paramedic providers may not charge fees 
for transporting a patient when the provider does not transport the patient.
(b)
The provisions of Subsection 
(3)(a)
(4)(a)
 do not apply to ambulance providers or 
paramedic providers in a geographic service area which contains a town as defined in 
Subsection 
10-2-301
(2)(f).
(5)
(a)
The base rate is as follows:
(i)
for emergency medical technician ground ambulance transport, $1,234.92;
(ii)
for advanced emergency medical technician ground ambulance transport, 
$1,630.31;
(iii)
for paramedic ground ambulance transport, $2,383.73; and
(iv)
subject to Subsection 
(5)(b)
, for a transport described in Subsection 
(5)(a)(i)
 or 
(ii) that has a paramedic on board, $2,383.73.
(b)
A ground ambulance provider may charge the rate described in Subsection 
(5)(a)
(iv) 
if:
(i)
a designated emergency medical service dispatch center dispatches a licensed 
paramedic provider to treat the individual;
(ii)
the licensed paramedic provider has initiated advanced life support;
(iii)
online medical control directs that a paramedic remain with the patient during 
transport; and
(iv)
the licensed ground ambulance provider has a reimbursement for paramedic 
services agreement with a paramedic licensed provider for the service provided.
(6)
(a)
For the mileage rate established in rule under this section, a ground ambulance 
provider or paramedic provider may not charge an amount greater than the amount 
authorized in the rule setting the mileage rate.
(b)
For the base rate, a ground ambulance provider or paramedic provider may not 
charge an amount greater than the base rate described in Subsection (5)(a) for 
transportation services.
(c)
For a medication, a ground ambulance provider or paramedic provider may not 
charge an amount greater than the medication maximum cost for a provided 
medication.
(7)
A ground ambulance provider or paramedic provider may not balance bill.
(8)
Subject to prioritization by the Legislative Audit Subcommittee, the Office of the 
Legislative Auditor General created in Section 
36-12-15
 shall conduct an audit of 
ground ambulance providers, paramedic providers, and insurance companies regarding 
rates and payments described in this section, Section 
31A-22-627.1
, and Section 
34A-2-407.1
.
Section 4, Section 
63I-1-231
 is amended to read:
63I-1-231
. Repeal dates: Title 31A.
(1)
Section 
31A-2-217
, Coordination with other states, is repealed July 1, 2033.
(2)
Section 
31A-22-627.1
, Ground ambulance reimbursement, is repealed July 1, 2027.
Section 5, Section 
63I-1-234
 is amended to read:
63I-1-234
. Repeal dates: Titles 34 and 34A.
(1)
Subsection 
34A-1-202
(2)(b)(i), regarding the Workers' Compensation Advisory 
Council, is repealed July 1, 2027.
(2)
Subsection 
34A-1-202
(2)(b)(iii), regarding the Coal Miner Certification Panel, is 
repealed July 1, 2034.
(3)
Section 
34A-2-107
, Appointment of workers' compensation advisory council -- 
Composition -- Terms of members -- Duties -- Compensation, is repealed July 1, 2027.
(4)
Section 
34A-2-202.5
, Offset for occupational health and safety related donations, is 
repealed December 31, 2030.
(5)
Section 
34A-2-407.1
, Ground ambulance transport, is repealed July 1, 2027.
Section 6, Section 
63I-1-253
 is amended to read:
63I-1-253
. Repeal dates: Titles 53 through 53G.
(1)
Section 
53-1-122
, Road Rage Awareness and Prevention Restricted Account, is 
repealed July 1, 2028.
(2)
Section 
53-2a-105
, Emergency Management Administration Council created -- 
Function -- Composition -- Expenses, is repealed July 1, 2029.
(3)
Section 
53-2a-1103
, Search and Rescue Advisory Board -- Members -- Compensation, 
is repealed July 1, 2027.
(4)
Section 
53-2a-1104
, General duties of the Search and Rescue Advisory Board, is 
repealed July 1, 2027.
(5)
Title 53, Chapter 2a, Part 15, Grid Resilience Committee, is repealed July 1, 2027.
(6)
Section 
53-2d-104
, State Emergency Medical Services Committee -- Membership -- 
Expenses, is repealed July 1, 2029.
(7)
Section 
53-2d-503
, Establishment of maximum rates, is repealed July 1, 2027.
(7)
(8)
Section 
53-2d-703
, Volunteer Emergency Medical Service Personnel Health 
Insurance Program -- Creation -- Administration -- Eligibility -- Benefits -- Rulemaking 
-- Advisory board, is repealed July 1, 2027.
(8)
(9)
Section 
53-5-703
, Board -- Membership -- Compensation -- Terms -- Duties, is 
repealed July 1, 2029.
(9)
(10)
Section 
53-11-104
, Board, is repealed July 1, 2029.
(10)
(11)
Section 
53-22-104.1
, School Security Task Force -- Membership -- Duties -- Per 
diem -- Report -- Expiration, is repealed December 31, 2025.
(11)
(12)
Section 
53-22-104.2
, The School Security Task Force -- Education Advisory 
Board, is repealed December 31, 2025.
(12)
(13)
Subsection 
53B-1-301
(1)(j), regarding the Higher Education and Corrections 
Council, is repealed July 1, 2027.
(13)
(14)
Section 
53B-7-709
, Five-year performance goals, is repealed July 1, 2027.
(14)
(15)
Title 53B, Chapter 8a, Part 3, Education Savings Incentive Program, is repealed 
July 1, 2028.
(15)
(16)
Title 53B, Chapter 17, Part 11, USTAR Researchers, is repealed July 1, 2028.
(16)
(17)
Section 
53B-17-1203
, SafeUT and School Safety Commission established -- 
Members, is repealed January 1, 2030.
(17)
(18)
Title 53B, Chapter 18, Part 16, USTAR Researchers, is repealed July 1, 2028.
(18)
(19)
Title 53B, Chapter 18, Part 17, Food Security Council, is repealed July 1, 2027.
(19)
(20)
Title 53B, Chapter 18, Part 18, Electrification of Transportation Infrastructure 
Research Center, is repealed July 1, 2028.
(20)
(21)
Title 53B, Chapter 35, Higher Education and Corrections Council, is repealed 
July 1, 2027.
(21)
(22)
Subsection 
53C-3-203
(4)(b)(vii), regarding the distribution of money from the 
Land Exchange Distribution Account to the Geological Survey for test wells and other 
hydrologic studies in the West Desert, is repealed July 1, 2030.
(22)
(23)
Subsection 
53E-1-201
(1)(q), regarding the Higher Education and Corrections 
Council, is repealed July 1, 2027.
(23)
(24)
Subsection 
53E-2-304
(6), regarding foreclosing a private right of action or 
waiver of governmental immunity, is repealed July 1, 2027.
(24)
(25)
Subsection 
53E-3-503
(5), regarding coordinating councils for youth in care, is 
repealed July 1, 2027.
(25)
(26)
Subsection 
53E-3-503
(6), regarding coordinating councils for youth in care, is 
repealed July 1, 2027.
(26)
(27)
Subsection 
53E-4-202
(8)(b), regarding a standards review committee, is repealed 
January 1, 2028.
(27)
(28)
Section 
53E-4-203
, Standards review committee, is repealed January 1, 2028.
(28)
(29)
Title 53E, Chapter 6, Part 5, Utah Professional Practices Advisory Commission, 
is repealed July 1, 2033.
(29)
(30)
Subsection 
53E-7-207
(7), regarding a private right of action or waiver of 
governmental immunity, is repealed July 1, 2027.
(30)
(31)
Section 
53F-2-420
, Intensive Services Special Education Pilot Program, is 
repealed July 1, 2024.
(31)
(32)
Section 
53F-5-214
, Grant for professional learning, is repealed July 1, 2025.
(32)
(33)
Section 
53F-5-215
, Elementary teacher preparation grant, is repealed July 1, 
2025.
(33)
(34)
Section 
53F-5-219
, Local Innovations Civics Education Pilot Program, is 
repealed July 1, 2025.
(34)
(35)
Title 53F, Chapter 10, Part 2, Capital Projects Evaluation Panel, is repealed July 
1, 2027.
(35)
(36)
Subsection 
53G-4-608
(2)(b), regarding the Utah Seismic Safety Commission, is 
repealed January 1, 2025.
(36)
(37)
Subsection 
53G-4-608
(4)(b), regarding the Utah Seismic Safety Commission, is 
repealed January 1, 2025.
(37)
(38)
Section 
53G-9-212
, Drinking water quality in schools, is repealed July 1, 2027.
Section 7. 
Effective Date.
This bill takes effect on 
May 7, 2025
.
3-11-25 3:25 PM