Georgia CommonsSenate · Engrossed · 2025-2026 Regular Session
SB 462: "Surprise Billing Consumer Protection Act"; insurance coverage for certain out-of-network ambulance transportation service; provide
Last action March 31, 2026 · House Passed/Adopted By Substitute
A Georgia Senate bill would require auto insurers to report profit data and refund excess profits to policyholders, and would set new payment rules for out-of-network ground ambulance services under health plans.
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 Comm Sub version, the latest the General Assembly's website lists.
In plain language
This bill amends Georgia's insurance code in two main ways. First, it revives a currently reserved section of law to require companies that sell private passenger auto insurance to report detailed financial data to the Department of Insurance every year starting July 1, 2028. If the Commissioner of Insurance finds an insurer made 'excess profit,' defined as underwriting gains exceeding expected profit plus 6 percent of earned premiums over five years, the Commissioner can order the company to refund policyholders in cash or as a credit toward renewal premiums, unless the refund would make the insurer insolvent. Second, the bill rewrites the ambulance billing section of Georgia's Surprise Billing Consumer Protection Act (O.C.G.A. § 33-20E-23). It sets minimum reimbursement rates health plans must pay out-of-network ground ambulance providers, caps what patients can be charged in copayments or coinsurance, and requires insurers to pay clean claims directly to ambulance providers within 30 days. Most provisions take effect July 1, 2026; the ambulance section takes effect January 1, 2027.
What the bill does
- Requires auto insurers writing private passenger policies in Georgia to file annual financial data with the Department of Insurance starting July 1, 2028.
- Lets the Commissioner of Insurance order refunds when an insurer's underwriting gains exceed anticipated profit plus 6 percent of earned premiums over a five-year period.
- Sets a minimum reimbursement rate health plans must pay out-of-network ground ambulance providers, based on local government agreements or a formula tied to Medicare rates.
- Caps copayments, coinsurance, or deductibles for out-of-network ambulance service at the same level charged for in-network ambulance service.
- Requires insurers to pay clean ambulance claims directly to the provider within 30 days and to notify providers of denials or missing information.
- Bars insurers that issue refunds under the excess profit rule from adjusting commission, premium tax, or other tax payments because of the refund.
Who it affects
Auto insurance companies and their policyholders in Georgia, the Department of Insurance and Commissioner of Insurance, ground ambulance providers (public and private), health insurers and health plan enrollees who use out-of-network ambulance transport, and local governments that set ambulance reimbursement rates by ordinance or contract.
Why it matters
Georgia drivers could see refunds if regulators determine their auto insurer earned excess profits, while patients who use an out-of-network ambulance would face capped copayments and be shielded from most billing beyond that, with insurers paying providers directly instead of billing patients.
Key provisions
- Section 1 revives O.C.G.A. § 33-9-41 to define 'excess profit' and require annual data filings from private passenger auto insurers starting July 1, 2028.
- Section 1 gives the Commissioner authority to order excess profit refunds as cash within 60 days or as a credit on renewal premiums, after notice and an opportunity for a hearing.
- Section 1 exempts an insurer from refunding excess profit if doing so would cause financial impairment or insolvency.
- Section 2 rewrites O.C.G.A. § 33-20E-23 to set minimum reimbursement rates for out-of-network ground ambulance service, using local agreements or 325 percent of Medicare rates as a default.
- Section 2 caps patient copayments, coinsurance, or deductibles for out-of-network ambulance service at in-network levels.
- Section 2 requires insurers to pay clean ambulance claims within 30 days directly to the provider, not the patient.
- Section 3 sets the general effective date as July 1, 2026, while the ambulance billing provisions in Section 2 take effect January 1, 2027.
From the bill
“'Excess profit' means an underwriting gain for the five most recent calendar accident years combined which is greater than the anticipated underwriting profit plus 6 percent of earned premiums for such calendar accident years.”
“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.”
“Any copayment, coinsurance, or deductible paid for covered service provided by an out-of-network ambulance provider shall not exceed the amount of a copayment, coinsurance, or deductible amount owed for similar service provided by an ambulance provider that belongs to the provider network”
Discussed in meetings (13)
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 Health and Human Services Committee, February 11, 2026
From 0:20:18 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said SB 462 would protect patients from surprise ground ambulance bills and require direct payment to providers within 30 days. A Georgia Ambulance Providers Association witness explained that covered out-of-network payments would follow a county rate or, without one, the lesser of billed charges or 325% of Medicare. Presenters said patients would owe no more than in-network cost-sharing and providers would absorb any remaining balance. Members described constituents facing large ambulance bills and asked about coverage, mileage and the proposed rate. Presenters said 911 dispatch requests qualify and mileage is included. Supporters from ACCG, ambulance organizations, hospitals and county services said reimbursement falls short of readiness and operating costs, shifting costs to taxpayers. A Henry County Fire Rescue witness estimated the bill would have brought $1.9 million more revenue in 2025 while avoiding billing patients that amount. The Georgia Association of Health Plans witness supported ending balance billing but argued that 325% could discourage network contracts, suggesting a lower or median contracted rate. The witness also raised possible state costs under newly announced federal benefit rules, without an estimate, and said state plans and federally regulated employer plans would be excluded. An ambulance association witness said emergency services already fall within essential benefits but had not reviewed the new federal document. No amendment was adopted. The committee approved the bill unanimously.
Senate Rules Committee, February 17, 2026
From 0:15:41 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said SB 462 would require health plans to treat emergency ambulance transportation as a covered service. The sponsor cited variation in ambulance charges as the reason for the consumer-protection proposal. The sponsor later selected the bill for floor consideration, and the committee unanimously approved a calendar containing this bill and two others.
Senate floor session, February 18, 2026 (legislative day 20)
From 3:03:03 · Watch on the General Assembly's Vimeo channel · Confirmed by the bill's status history (Senate Third Read)
Summary by Georgia Commons: The sponsor said SB 462 would protect patients from unexpected out-of-network ambulance bills because people calling 911 cannot choose their ambulance provider or know the charge beforehand. The sponsor said the measure would set reimbursement at 3.25 times the Medicare rate, giving approximate examples of $800 for basic life-saving service and $1,700 for advanced life-saving service. The clerk’s reading also described limits on patient copayments, coinsurance and deductibles. No questions or additional speeches followed. The Senate passed the bill 51-1.
House floor session, March 9, 2026 (legislative day 29)
From 1:41:50 · Watch on the General Assembly's Vimeo channel · Confirmed by the bill's status history (House Withdrawn, Recommitted)
Summary by Georgia Commons: A committee chair requested that SB 462, which the clerk described as amending the Surprise Billing Consumer Protection Act, be moved from the Health Committee to the Insurance Committee. The member making the motion said both committee chairs agreed. The House approved the transfer without objection, with no discussion of the bill's substance.
House Insurance Committee, March 20, 2026
From 0:25:12 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said SB 462 would prevent surprise billing by limiting private emergency ground-ambulance charges to 325% of the Medicare rate, excluding nonemergency and air transportation. The sponsor confirmed that the ambulance provisions were unchanged from the Senate version and would take effect January 1, 2027. The substitute also incorporated HB 1344, HB 1262, HB 1263 and HB 1274. One member supported the additions as insurance-affordability measures; another said members needed time to understand them and might vote no for that reason. A witness for the Association of County Commissioners of Georgia supported the ambulance provisions as helpful to rural and smaller counties. A second association witness objected to added county reporting requirements, saying they duplicated existing reports and conflicted with restrictions on spending premium-tax revenue. After initially approving the substitute, the committee reconsidered it. A member offered replacement language requiring annual reports beginning January 1, 2027, showing legally authorized spending, or allowing counties to submit an existing required budget report. The committee adopted the amendment and approved the amended bill by voice vote, with no count stated.
House Rules Committee, March 31, 2026
From 0:53:11 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 3954
Summary by Georgia Commons: The sponsor said SB 462, described as an ambulance surprise-billing proposal, had grown into a 45-page measure with additions from the House Insurance Committee. The sponsor mentioned work with House members but did not explain the added provisions. There were no questions or recorded decisions.
House floor session, March 31, 2026 (legislative day 39, part 2)
From 2:37:11 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 3977
Summary by Georgia Commons: The presenter said the Rules Committee reduced the bill from about 40 pages to seven, retaining surprise ambulance billing protections and an automobile insurance excess-profits provision modified in the Senate. The presenter described both as insurance affordability measures and said other provisions were expected to return in another bill. No members asked questions. The House adopted the Rules Committee substitute and passed the bill, 167 to 0.
House Rules Committee, March 31, 2026
From 0:25:00 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 3954
Summary by Georgia Commons: The presenter said the substitute combined surprise ambulance-billing provisions with excess-profits legislation. The presenter explained that broader insurance-affordability provisions previously attached to the bill had been removed by the Senate, which had enacted most of those provisions elsewhere. A committee member asked what percentage had increased. The presenter answered that the earlier ambulance-billing version used 300% of Medicare and the Senate version used 325%, which was the agreed amount. The committee approved substitute LC52-1122S without stated opposition and later placed it on the supplemental floor calendar without stated opposition.
- Read aloud: Senate floor session, February 5, 2026 (legislative day 13), 0:24:51
- Read aloud: Senate floor session, February 12, 2026 (legislative day 18), 0:26:11
- Read aloud: Senate floor session, February 17, 2026 (legislative day 19), 0:35:31
- Read aloud: House floor session, February 19, 2026 (legislative day 21), 0:34:54
- Read aloud: House floor session, February 20, 2026 (legislative day 22), 0:45:04
Status timeline
- House Passed/Adopted By Substitute (House)
- House Third Readers (House)
- House Committee Favorably Reported By Substitute (House)
- House Withdrawn, Recommitted (House)
- House Second Readers (House)
- House First Readers (House)
- Senate Passed/Adopted (Senate)
- Senate Third Read (Senate)
Show full history (12 actions)
- Senate Read Second Time (Senate)
- Senate Committee Favorably Reported (Senate)
- Senate Read and Referred (Senate)
- Senate Hopper (Senate)
Sponsors
- Shawn Still (R, SD-48)
- Jason Anavitarte (R, SD-31)
- Ben Watson (R, SD-1)
- Sally Harrell (D, SD-40)
- Bo Hatchett (R, SD-50)
- Sonya Halpern (D, SD-39)
- Chuck Hufstetler (R, SD-52)
- Kay Kirkpatrick (R, SD-32)
- Matt Reeves (R, HD-99)
Votes
- Senate voteFebruary 18, 2026
51 yea, 1 nay (0 not voting, 2 excused)
- House voteMarch 31, 2026
167 yea, 0 nay (4 not voting, 5 excused)
Topics
- auto insurance regulation
- surprise medical billing
- ambulance services
- insurance refunds
- health insurance