SB 916 Would Continue the 2023 Texas Law, Which Was Agreed to by the Health Plans, EMS Agencies and Lawmakers, to Remove Patients From Ground Ambulance Billing Disputes

Austin – February 10, 2025 – The Texas Emergency Medical Services Alliance (TEMSA) issued its support for SB 916, which seeks to extend key patient protections enacted in 2023 under SB 2476 (88-R).

The current law shields Texans who are insured under state-regulated commercial plans from out-of-network billing disputes for ground ambulance. However, the 2023 law features a sunset, and it must be addressed in the 2025 Texas Legislature.

“The 2023 Texas law passed by Sen. Judith Zaffirini and Rep. Tom Oliverson, MD, demonstrated that patients benefit when all stakeholders in the health care system – lawmakers, health plans and providers – work together,” said Butch Oberhoff, TEMSA’s president. “Everyone worked together to remove patients from out-of-network billing disputes and also ensure that EMS agencies are paid sustainable rates that will enable them to continue delivering life-saving 9-1-1 care to Texas communities.”

SB 2476 (88-R) banned balance billing for ground EMS services covered by state-regulated health plans. In exchange, health plans were directed to pay the ground EMS rate set by governmental entities. If a rate does not exist, health plans are then required to pay 325 percent of the current Medicare rate.

The federal government’s No Surprises Act (NSA) featured a ban on balance billing for all providers that are governed by ERISA plans and in states in which the state-regulated plans did not have a ban on balance billing. However, the NSA created an exception for ground ambulance to continue to balance bill until Congress reached a solution for out-of-network payments for ground EMS covered by both federal and state regulated commercial insurance plans.

SB 2476 (88-R) featured a sunset after two years with the expectation that Congress would reach a conclusion on ground EMS out-of-network billing. However, Congress has failed to act, which makes SB 916 (89-R) necessary to extend the 2023 law in Texas.

“It is critical for the 2025 Texas Legislature and health care stakeholders to come together once again to pass SB 916,” said Oberhoff. “The 2023 law benefited Texas patients, and patients deserve and expect for these vital protections to remain in place.”

SB 916 would continue the 2023 law, SB 2476 (88-R). In addition, SB 916 would also grant the Texas Department of Health Services (DSHS) authority to discipline EMS agencies for submitting incorrect information or engaging in repeated violations of the Texas Insurance Code.

About the Texas EMS Alliance

The Texas EMS Alliance (TEMSA) was founded in 2014 to serve as the unified voice of Texas EMS agencies. Over 90 urban and rural EMS agencies that provide 911 services to their communities are TEMSA members.

Visit www.txemsa.com to learn more about EMS in Texas.