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PWW reports – No Surprises Act does NOT apply to ground ambulance

New Federal clarification that NSA doesn’t apply to ground ambulance aligns with longstanding PWW guidance
An upcoming Federal Register notice provides further clarification of the fact that ground ambulance services are not included in the Federal No Surprises Act, which prohibits balance billing for air ambulance services.  The Feds’ latest statement on the subject says:

         “The Departments have received questions about how the surprise billing protections under the No Surprises Act apply to ground ambulance services. In particular, the Departments understand that some plans and issuers have construed a statement in the preamble to the July 2021 interim final rules addressing when a participant, beneficiary, or enrollee is in a condition to receive notice and provide consent to waive surprise billing protections for post-stabilization services188 to mean that the No Surprises Act surprise billing protections apply to post stabilization inter-facility ground ambulance transports. The Departments do not interpret the No Surprises Act’s surprise billing provisions to apply to emergency or non-emergency ground ambulance services.

 (Emphasis added.)  Although this Federal Register guidance is new, it is not new that the NSA has never applied to ground ambulance services.  PWW has issued guidance since the NSA was first passed that it does not apply to ground ambulance services, and that insurers who were saying otherwise were simply wrong.

 In our December 9, 2022 e-mail bulletin, PWW said: “The Federal No Surprises Act currently only prevents balance billing for air ambulance services.” 

 In our March 9, 2023 bulletin, PWW said: “the NSA does not currently apply to ground ambulance services – a fact that some commercial insurers have chosen to ignore.”
We’ve been clear and steadfast about the non-applicability of the NSA to ground ambulance services in all our communications since the law was first enacted – including at our abc360 conferences. Yet, some commercial insurers have improperly led ambulance services to believe otherwise, affecting the bottom line of many EMS organizations, who are already operating on thin margins.  While Congress may choose to amend the NSA to make it applicable to ground ambulance services in the future, it is crystal clear that it does not apply now, and has never applied, to ground ambulance services.
Where you get your information matters.  It is vital to stay up-to-date on the reliable sources of industry insight and analysis from PWW, your association partners, and other reliable sources. Don’t always accept what insurers and others tell you about your rights and obligations.  Stay informed, and stay vigilant!  CLICK HERE for full Federal Register notice.  
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