May 22, 2025 – AUSTIN – The Texas EMS Alliance (TEMSA) commends both chambers of the Texas Legislature for unanimously passing SB 916, which extends a landmark patient protection bill originally passed by the 2023 Legislature. SB 916 will protect Texans insured by state-regulated health plans from unexpected medical bills for ground ambulance services while ensuring that EMS agencies across the state receive fair and sustainable reimbursement, enabling them to continue delivering essential 9-1-1 emergency care and interfacility transports to Texas communities.

“The 2023 Texas law demonstrated that patients benefit when all stakeholders in the health care system – lawmakers, health plans and EMS agencies – work together,” said Butch Oberhoff, TEMSA’s president. “TEMSA applauds the 2025 Texas Legislature for unanimously passing SB 916 to extend the 2023 protection to Texans.”

SB 916 (89-R) continues the ban on balance billing for ground EMS services covered by state-regulated health plans.  Under this law, health plans must pay ground EMS providers at a rate set by local governmental entities. If locally set rates do not exist or have not been reported to the state, health plans are required to pay at 325 percent of the current Medicare rate, ensuring that EMS agencies receive sustainable reimbursement.

The 2023 law, SB 2476, featured a two-year sunset with the expectation that Congress would reach a conclusion on out-of-network ground ambulance billing at the federal level. The federal No Surprises Act (NSA) prohibited balance billing for most providers under ERISA plans and in states with state-regulated plans, but could not come to a consensus that would address ground ambulance services. As a result, implementation of the NSA as it applies to ground ambulance service was delayed until Congress could reach a nationwide solution. SB 916 fills this gap for Texans by protecting patients from out-of-network bills for ground EMS covered by state-regulated commercial insurance plans.

Oberhoff added: “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.”