Tennessee Senate Bill SB1376

Tennessee 2025-2026 Regular Session

• Introduced: 2/6/25
• Failed: 4/7/26

Caption

AN ACT to amend Tennessee Code Annotated, Title 56, Chapter 7 and Title 68, Chapter 140, relative to no surprise ambulance billing.

Summary

SB1376 would prohibit out-of-network ambulance service providers from balance billing insured patients for covered ambulance services under health benefit plans issued or renewed on or after July 1, 2025. The bill defines key terms such as ambulance, ambulance service, balance billing, emergency medical condition, health benefit plan, and health insurer, and applies only to ambulance transport tied to an emergency medical condition. Under the bill, an enrollee’s payment obligation for out-of-network ambulance services would be limited to the lesser of the plan’s in-network cost-sharing amount, the provider’s billed charges, or 325% of the current CMS published rate for the same service in the same geographic area. Health insurers would be required to count that cost-sharing toward the enrollee’s deductible and out-of-pocket maximum as if the service were in-network. The bill also bars ambulance organizations from requiring patients to sign waivers or other documents that would waive or alter these protections.

Impact

The bill would amend Tennessee Code Annotated Title 56, Chapter 7, Part 23, creating new consumer protections for insured patients who receive emergency ambulance transport from out-of-network providers. It would limit what ambulance providers may collect directly from enrollees, shift the remaining payment dispute to the insurer/provider relationship, and require insurers to apply the patient’s payment toward deductible and out-of-pocket limits. The measure would take effect July 1, 2025, and would apply to health benefit plans issued or renewed on or after that date.

Sentiment

The bill’s policy direction appears consumer-protective, aiming to reduce surprise medical bills for ambulance transport and align ambulance billing with broader no-surprise-billing reforms. However, the recorded committee vote shows the measure failed in the Senate Commerce and Labor Committee by a 4-5 vote, indicating insufficient support at that stage despite the consumer-facing intent.

Contention

The likely point of contention is the financial impact on ambulance service providers and insurers, particularly the bill’s cap on patient liability at 325% of the CMS rate and its prohibition on balance billing. Supporters would view the bill as protecting patients from unexpected emergency transportation charges, while opponents may argue it constrains provider reimbursement, especially for out-of-network ambulance services, and could affect ambulance system finances or network negotiations. The failed committee vote suggests these reimbursement and market-impact concerns outweighed support in committee.