Georgia Caps Ambulance Costs at Medicare Rates in Surprise Billing Protection

**TL;DR:** Georgia lawmakers sent Gov. Brian Kemp legislation that would cap insurance costs for ambulance rides at a multiple of Medicare rates, eliminating surprise bills for patients.

Emergency medical transportation has long been a blind spot in consumer protections against surprise medical billing. When someone calls 911 after a heart attack, car crash or serious injury, they have no choice but to accept whatever ambulance the first responder dispatches. That provider may be outside their insurance network, leaving patients on the hook for the difference between what their insurer pays and what the ambulance company bills. Georgia's legislature moved to close that gap in the final hours of this year's session.

House Bill 506 caps insurance costs for any ambulance ride requested by a first responder at a multiple of Medicare rates. Patients would pay the same out-of-pocket costs whether the ambulance provider is in-network or out-of-network. The Senate passed HB 506 unanimously Tuesday, and the House approved it Thursday with only one dissenting vote. The bill would take effect Jan. 1 if Kemp signs it into law.

The legislation emerged from an unlikely vehicle. The underlying bill began last year as a tobacco cessation measure. The Senate retrofitted it as a carrier for the ambulance billing language, with Sen. Shawn Still, R-Suwanee, responsible for overlaying HB 506 with the new provisions.

The change addresses a fundamental power imbalance in emergency care. Patients cannot negotiate prices while being rushed to a hospital. "If someone has private insurance, that will be billed rather than self-pay on an ambulance ride," Still said. Rep. Alan Powell, R-Hartwell, who sponsored a similar House measure that stalled in the Senate, put it more bluntly: "If I have a heart attack, I'm not going to negotiate. Get me to the hospital quick!"

What it means: Georgians with private insurance would gain protection from one of the most unpredictable gaps in healthcare billing. The cap ties reimbursement to Medicare rates, a baseline that typically falls below commercial insurance payments but provides a floor for fair compensation. Patients would no longer face wildly different out-of-pocket costs depending on which ambulance happened to respond. The governor's decision will determine whether that protection takes effect in 2025.