Bill Text: NH SB130 | 2025 | Regular Session | Amended
Bill Title: Establishing a commission to study delivery models for emergency medical services in the state of New Hampshire.
Sponsorship: Partisan Bill (Republican 4)
Status: (Engrossed - Dead) 2025-05-22 - Inexpedient to Legislate: Motion Adopted DV 184-178 05/22/2025 House Journal 15 P. 25 [SB130 Detail]
Download: New_Hampshire-2025-SB130-Amended.html
SB 130-FN - AS AMENDED BY THE SENATE
03/06/2025 0402s
2025 SESSION
25-1034
05/08
SENATE BILL 130-FN
SPONSORS: Sen. Rochefort, Dist 1; Sen. McGough, Dist 11; Rep. Korzen, Coos 7; Rep. Miles, Hills. 12
COMMITTEE: Health and Human Services
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AMENDED ANALYSIS
This bill establishes a commission to study delivery models for emergency medical services in the state of New Hampshire.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/06/2025 0402s 25-1034
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Five
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Subdivision; Commission to Study Delivery Models for Emergency Medical Services. Amend RSA 153-A by inserting after section 37 the following new subdivision:
Commission to Study Delivery Models for Emergency Medical Services
153-A:38 Commission to Study Delivery Models for Emergency Medical Services.
I. There is established a commission to study delivery models for emergency medical services in the state of New Hampshire.
II. Notwithstanding RSA 14:49, the members of the commission shall be as follows:
(a) Three members of the house of representatives, appointed by the speaker of the house of representatives. At least one member of each party shall be appointed, and at least one member representing Coos County shall be appointed.
(b) One member of the senate, appointed by the president of the senate.
(c) A representative from the department of safety, appointed by the commissioner.
(d) A representative from the New Hampshire Fire Chiefs Association, appointed by the association.
(e) A representative from the New Hampshire Ambulance Association, appointed by the association.
(f) A representative from the Professional Firefighters of New Hampshire, appointed by the association.
(g) A representative from the New Hampshire Hospital Association, appointed by the association.
(h) A representative from the New Hampshire Municipal Association, appointed by the association.
(i) A representative from the New Hampshire Association of Counties, appointed by the association.
(j) A representative from AHIP, appointed by the association.
III. Legislative members of the commission shall receive mileage at the legislative rate when attending to the duties of the commission.
IV. The commission shall:
(a) Review the history and operation of emergency medical services delivery in New Hampshire and the current models adopted by municipalities in New Hampshire for emergency responses.
(b) Review the systems response to both emergency calls for assistance, unscheduled emergency transfers and non-emergency transfers.
(c) Identify the barriers to providing emergency medical services in New Hampshire, including access to EMS services in rural communities, interfacility transfers, and the provision of advanced life support.
(d) Examine what part or parts of the state could benefit from regional emergency medical services models of care.
(e) Identify recommendations to support and build sustainable emergency medical systems in New Hampshire.
V. The members of the study commission shall elect a chairperson from among the members. The first meeting of the commission shall be called by the first-named house member. The first meeting of the commission shall be held within 45 days of the effective date of this section. Four members of the commission shall constitute a quorum.
VI. The commission shall report its findings and any recommendations for proposed legislation to the speaker of the house of representatives, the president of the senate, the house clerk, the senate clerk, the governor, the state library, and the New Hampshire Historical Society on before November 1, 2025.
2 Repeal. RSA 153-A:38 and the subdivision heading preceeding RSA 153-A:38, relative to the commission to study delivery models for emergency medical services, is repealed.
I. Section 2 of this act shall take effect November 1, 2025.
II. The remainder of this act shall take effect upon its passage.
25-1034
Revised 2/6/25
SB 130-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to insurance reimbursement for ambulance services.
FISCAL IMPACT: This bill does not provide funding, nor does it authorize new positions.
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Estimated State Impact | ||||||
| FY 2025 | FY 2026 | FY 2027 | FY 2028 | ||
Revenue | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase | ||
Revenue Fund(s) | General Fund - Insurance Premium Tax | |||||
Expenditures* | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
Appropriations* | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill | ||||||
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Estimated Political Subdivision Impact | ||||||
| FY 2025 | FY 2026 | FY 2027 | FY 2028 | ||
County Revenue | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase | ||
County Expenditures | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase | ||
Local Revenue | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase | ||
Local Expenditures | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase | ||
METHODOLOGY:
This bill prohibits health carriers and providers from balance billing for ambulance services and establishes parameters for reimbursement of ground ambulance services by participating and nonparticipating ambulance service providers.
The Insurance Department assumes any county or municipality that sets a rate would not set a rate less than 325% of Medicare as this is the least amount that could be collected for the services. The minimum rate of 325% of Medicare is a significant increase from the current rates at which health carriers are reimbursing providers for these services. The increase in costs would exert upward pressure on future premiums, as carriers design their plans to consider reimbursement to providers and the covered person’s cost sharing liability. The $100 cap on cost-sharing could also cause premiums to increase or the cost-sharing associated with other services to increase. The total extent of this impact is indeterminable at this time. In the event that appreciable increases in premium result from the bill, the Department would expect an increase in premium tax revenue. To the extent that local and county governments purchase health insurance, they may see increased premiums. Localities and counties that provide ambulance services will also be impacted since the rate schedule will set the amount recoverable for ambulance services. The extent of this impact will vary by locality and is therefore indeterminable.
The Department indicates it used a consultant to assist with a financial impact estimate on Commercial Market Premiums. Using a similar cost estimate methodology the consultant used for a NH ground ambulance cost study, this bill is estimated to result in a $1.13-$1.38 per member per month (PMPM) increase to premiums in the Commercial market. This translates to an approximate 0.5% increase in premium PMPM or an estimated $15,000,000 in aggregate. This estimate is based on the New Hampshire All Payer Claims Database (APCD) Commercial and Medicare Ambulance claims data for calendar year 2023. This estimate assumes rates of 325% of Medicare. The Department notes that the impact will likely be greater as local governments could set rates higher than 325% of Medicare.
The Department of Health and Human Services states the guidelines in the NH Insurance Department Bulletin Docket No. INS No. 12-015-AB address the applicability of state insurance laws to Medicaid Health Maintenance Organizations (HMOs). Under the current guidance, the addition of the new section, 8-i to RSA 420-J would not have an impact on the Department’s budget.
AGENCIES CONTACTED:
Departments of Insurance and Health and Human Services
