CommercialReimbursementMedium impact
23-1468m Find Out What's Changing: Billing Members for Ground Ambulance Transportation
Health Net·CA · Emergency Medicine, Critical Care·Reimbursement
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Effective January 1, 2024, California Assembly Bill 716 prohibits non-contracted ground ambulance providers from balance billing Health Net members above in-network cost-sharing amounts. Billing teams must ensure members are only charged their in-network cost share for ground ambulance services, regardless of whether the ambulance provider is contracted or not.
Action Required
Immediately: Billing team must update system to apply in-network cost sharing for all ground ambulance transportation claims, even when provided by non-contracted ambulance services. Ensure provider remittance advice and member explanation of benefits reflect that members are not responsible for charges beyond their in-network cost share. Contact Health Net for reimbursement of the difference between member cost-sharing and full payment amount for non-contracted ambulance services.