Georgia CommonsHouse · Passed · 2025-2026 Regular Session
HB 506: Social services; Medicaid coverage for tobacco cessation treatments; provide
Last action May 12, 2026 · Act 624
House Bill 506 would set new rules for how Georgia insurers pay out-of-network ground ambulance providers, capping what patients owe and requiring faster insurer payments starting January 1, 2027.
The summaries below were written by an AI model (claude-sonnet-5) from the text of the bill and are not part of it. Quote the text, not the summary. The stored text is the Enrolled version, the latest the General Assembly's website lists.
In plain language
Currently, Georgia's Surprise Billing Consumer Protection Act (O.C.G.A. Chapter 20E of Title 33) says nothing reduces a patient's financial responsibility for ground ambulance transportation, leaving patients exposed to potentially large bills when an ambulance isn't in their insurance network. This bill rewrites that section entirely. It requires health plans to treat emergency ambulance transport as a covered service whenever a first responder calls for it. It sets a minimum reimbursement rate insurers must pay out-of-network ambulance providers, based on local government agreements where they exist, or otherwise the lesser of 325% of the Medicare ambulance rate or the provider's billed charges. Patients cannot be billed beyond their normal copayment, coinsurance, or deductible, and that amount cannot exceed what they'd owe for an in-network ambulance. Insurers must pay clean claims within 30 days directly to the provider, not the patient. The changes take effect January 1, 2027.
What the bill does
- Rewrites O.C.G.A. § 33-20E-23 to require health plans to cover emergency ambulance transport requested by a first responder.
- Sets a minimum reimbursement rate for out-of-network ground ambulance providers, based on local agreements or 325% of the Medicare ambulance rate if none exists.
- Caps patient copayments, coinsurance, and deductibles for out-of-network ambulance service at the same level charged for in-network service.
- Releases patients from further payment once an insurer pays the ambulance provider, aside from normal cost-sharing.
- Requires insurers to pay clean ambulance claims within 30 days directly to the provider, or explain denials or request more information within that time.
- Sets the new rules to take effect January 1, 2027.
Who it affects
Georgia residents who use ground ambulance services, especially those transported by out-of-network providers; health insurers regulated under Georgia law; ambulance providers, including those run by cities, counties, and private companies; and local governments that may set reimbursement rates by ordinance or contract.
Why it matters
Patients who get an out-of-network ambulance during an emergency would face capped, predictable out-of-pocket costs instead of open-ended bills. Ambulance providers would get a guaranteed minimum payment and faster processing, while insurers would face new payment deadlines and rate requirements starting in 2027.
Key provisions
- Section 1 replaces the current one-sentence version of O.C.G.A. § 33-20E-23 with detailed definitions of terms like 'ambulance provider,' 'clean claim,' 'covered service,' 'emergency transport service,' and 'first responder.'
- Subsection (b) requires health plans to treat ambulance transport requested by a first responder as a covered service.
- Subsection (c) sets the minimum reimbursement rate for out-of-network ambulance providers: a local government-agreed rate if one exists, or otherwise the lesser of 325% of the Medicare ambulance rate or the billed charges.
- Subsection (d) says paying the ambulance provider releases the patient from further payment beyond normal copayment, coinsurance, or deductible.
- Subsection (e) caps out-of-network ambulance cost-sharing at the same level as in-network cost-sharing.
- Subsection (f) requires insurers to pay clean claims within 30 days directly to the ambulance provider, and to respond in writing within 30 days to claims that are denied or need more information.
- Section 2 sets the effective date as January 1, 2027.
- Section 3 repeals conflicting laws.
From the bill
“A healthcare plan shall consider emergency transport service as a covered service when such emergency transport service is requested by a first responder.”
“No later than 30 days after the receipt of a clean claim for covered service, an insurer shall remit payment for such service directly to the ambulance provider and shall not remit any payment to a covered person.”
Discussed in meetings (7)
The House and Senate meetings that took this bill up, from their machine transcripts. Each account was written by Georgia Commons with AI and is not part of the record; the video is what was said.
Senate floor session, February 5, 2026 (legislative day 13)
From 1:43:22 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: A senator urged passage of HB 506 during personal remarks, saying it would remove barriers to tobacco cessation treatment and make access more consistent across Medicaid fee-for-service and managed-care coverage. Drawing on personal experience quitting smoking, the senator emphasized counseling, group programs and medications. The senator said Medicaid participants were more than twice as likely to smoke as privately insured people, Georgia spent $699 million annually on tobacco-related Medicaid costs, and a 1% reduction in smoking among Medicaid participants would save $38 million the next fiscal year. The senator urged bipartisan support, arguing that the bill could save lives and money. No vote occurred.
Senate Health and Human Services Committee, March 23, 2026
From 0:32:26 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor presented a substitute adding emergency medical services to the Surprise Billing Consumer Protection Act. The sponsor described receiving a large ambulance bill after a family member's allergic reaction as the reason for pursuing the change. The chair said the substitute matched language previously approved by the committee and Senate, including a 325% provision, but did not explain that provision further. When a committee member asked about including vaping, the sponsor clarified that the bill's original smoking-cessation provisions had been removed. The chair recorded a person signed up to testify as supporting the substitute without taking extended testimony. The committee approved the substitute unanimously.
Senate Rules Committee, March 25, 2026
From 0:33:53 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The presenter requested consideration of HB 506, which was not on the consideration sheet, and described it as addressing surprise emergency medical services billing. No further explanation or action was shown.
Senate Rules Committee, March 30, 2026
From 0:46:51 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor described HB 506 as addressing surprise emergency medical services bills. During selections, a committee member clarified that it was an ambulance measure, that its contents differed from the listed description, and that a substitute had been adopted. No details of the billing changes were given. The committee unanimously approved the calendar containing it.
Senate floor session, March 31, 2026 (legislative day 39, part 1)
From 7:15:44 · Watch on the General Assembly's Vimeo channel · Confirmed by the bill's status history (Senate Third Read)
Summary by Georgia Commons: The sponsor explained that the committee substitute replaced HB 506's tobacco cessation provisions with ambulance billing legislation. The clerk described insurance coverage for certain out-of-network ambulance services, minimum reimbursement rates and limits on patient copayments, coinsurance and deductibles. The sponsor said the language was identical to legislation the Senate had passed on February 18. No questions or opposing speeches followed. The Senate adopted the substitute and passed the bill 48-0.
House floor session, April 2, 2026 (legislative day 40, AM)
From 1:38:13 · Watch on the General Assembly's Vimeo channel · Confirmed by the bill's status history (House Agreed Senate Amend or Sub)
Summary by Georgia Commons: The sponsor said the Senate substitute for HB 506 removed all of the original Medicaid tobacco cessation language and replaced it with emergency medical services surprise-billing provisions. The sponsor said the replacement language had already passed the House twice, most recently 167 to 0. A member asked whether tobacco cessation provisions had therefore not passed or remained eligible for consideration that day, and the sponsor confirmed that understanding. The House agreed to the Senate substitute, 168 to 2.
Status timeline
- Effective Date
- Act 624
- House Date Signed by Governor (House)
- House Sent to Governor (House)
- House Agreed Senate Amend or Sub (House)
- Senate Passed/Adopted By Substitute (Senate)
- Senate Third Read (Senate)
- Senate Committee Favorably Reported By Substitute (Senate)
Show full history (20 actions)
- Senate Recommitted (Senate)
- Senate Taken from Table (Senate)
- Senate Tabled (Senate)
- Senate Read Second Time (Senate)
- Senate Committee Favorably Reported (Senate)
- Senate Read and Referred (Senate)
- House Passed/Adopted (House)
- House Third Readers (House)
- House Committee Favorably Reported (House)
- House Second Readers (House)
- House First Readers (House)
- House Hopper (House)
Sponsors
- Scott Hilton (R, HD-48)
- Karen Mathiak (R, HD-82)
- Deborah Silcox (R, HD-53)
- Ron Stephens (R, HD-164)
- Michelle Au (D, HD-50)
- Shawn Still (R, SD-48)
Votes
- House voteMarch 6, 2025
142 yea, 31 nay (1 not voting, 6 excused)
- Senate voteMarch 31, 2026
48 yea, 0 nay (0 not voting, 6 excused)
- House voteApril 2, 2026
168 yea, 2 nay (2 not voting, 4 excused)
Topics
- ambulance billing
- health insurance
- surprise medical bills
- emergency medical services
- out-of-network coverage