- PRESS RELEASE - 

NHAA URGES FAIR REIMBURSEMENT FOR

GROUND AMBULANCE PROVIDERS

New Hampshire Ambulance Service Expresses Concerns Over Legislative

Proposals Setting Commercial Insurance Reimbursement Rates Below

True Cost of Essential Service

CONCORD – The New Hampshire Ambulance Association expressed concerns about a series of legislative proposals aimed at setting a statewide reimbursement rate for ground ambulance services, explaining to lawmakers that the proposed rates do not reflect actual costs and need to be adjusted in order to protect consumers.

House Bill 316 and House Bill 185 are both being heard by the New Hampshire House Commerce Committee. Both bills attempt to create a framework to provide consistency and clarity in billing for ambulance calls, whether they are in urban or rural settings.  NHAA spoke out against the proposed rates, urging lawmakers to use national standards that are a more accepted practice and preserve the ambulance providers’ ability to continue offering care to patients throughout the state.

“By choosing to continue to reimburse NH’s ambulance providers below cost, the commercial insurance providers in NH continue to force ambulance providers to balance bill patients so they can attempt to recoup their operating costs,” explains Derick Aumann, President of the New Hampshire Ambulance Association. “If these rates are passed into law, it will certainly drive a number of current ambulance providers out of business in this state.”

“Ground ambulance providers are essential services and integral parts of the communities they serve,” says Nate Borland, Vice President of NHAA and a former North Country Ambulance provider. “Rural NH communities will be deeply impacted by the rates. Smaller agencies and towns that rely on volunteer ambulance services will either face cutbacks in service or local residents will face property tax hikes to make up the difference.”

NHAA members support the framework proposed by the New Hampshire Department of Insurance to establish statewide rates for urban, rural and super rural areas, for better transparency. But House Bills 316 and 185 fall short of a sustainable rate for ambulance providers. The Association urges lawmakers to work with providers and the insurance industry to increase the rates to reflect today’s expenses.

“The rates recommended, which are essentially 197% of the 2025 NH Medicare rate, do not reflect the impact of the loss of revenue that NH ambulance providers would experience if they were no longer allowed to balance bill,” says Chris Stawasz, Regional Director for American Medical Response & member of the NHAA Board of Directors. “Mandating those recommended rates and prohibiting balance billing would result in a significant net loss to NH ambulance providers which would put further financial pressure on an EMS system already in crisis.”  NHAA urges lawmakers to review the national standard for reimbursement, which is currently approximately 325% of the Medicare rate. This standard reflects the fact that nearly two-thirds of all ambulance calls are for patients who are currently on Medicare.

The remainder of calls are for Medicaid patients, those on private commercial insurance and those without any insurance coverage.  The NHHA fully supports action to protect consumers from balance billing practices and regulations that ensure adequate reimbursement for ground ambulance providers for the vital services they provide. Several states have issued reimbursement guidance that defers to local fee schedules and rates first before pursuing an alternate method. NHAA believes that this should be the route NH considers moving forward.

“There is a balance that can be struck where ambulance providers statewide can be properly reimbursed for the true costs of this essential service while preserving affordable insurance rates without a need for balance billing,” says Aumann. “The framework proposed is a good start, let’s just get the numbers right.”

About NHAA:

The New Hampshire Ambulance Association is dedicated to ensuring fair and adequate reimbursement and equitable access to emergent and non-emergent ambulance transport services across the state. We advocate for policies and practices that support financial sustainability and accessibility, protecting the health and safety of every resident and visitor in New Hampshire. By fostering collaboration, innovation, and continuous improvement, we strive to support the well-being of our communities. Mission: To unite and empower ambulance service providers across New Hampshire in securing proper reimbursement and delivering exceptional emergent and non-emergent medical transportation services. The NHAA will advocate for equitable funding models, accessible transportation, and resources that improve outcomes for those in need while ensuring the financial stability of providers.