HB 506: Social services; Medicaid coverage for tobacco cessation treatments; provide

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.

• 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.

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.

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.

• 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.

1. 2026-05-12Effective Date 2027-01-01
2. 2026-05-12Act 624
3. 2026-05-12House Date Signed by Governor (Cámara de Representantes)
4. 2026-04-10House Sent to Governor (Cámara de Representantes)
5. 2026-04-02House Agreed Senate Amend or Sub (Cámara de Representantes)
6. 2026-03-31Senate Passed/Adopted By Substitute (Senado)
7. 2026-03-31Senate Third Read (Senado)
8. 2026-03-25Senate Committee Favorably Reported By Substitute (Senado)

• Scott Hilton (R, HD-048)Patrocinador principal
• Karen Mathiak (R, HD-082)
• Deborah Silcox (R, HD-053)
• Ron Stephens (R, HD-164)
• Michelle Au (D, HD-050)
• Shawn Still (R, SD-048)

1. AprobadaVotación: Cámara de Representantes6 de marzo de 2025

   142 a favor, 31 en contra (1 sin votar, 6 ausentes)

   Passage: House Vote #258

2. AprobadaVotación: Senado31 de marzo de 2026

   48 a favor, 0 en contra (0 sin votar, 6 ausentes)

   Passage By Substitute: Senate Vote #894

3. AprobadaVotación: Cámara de Representantes2 de abril de 2026

   168 a favor, 2 en contra (2 sin votar, 4 ausentes)

   Agree To Senate Substitute: House Vote #835

• ambulance billing
• health insurance
• surprise medical bills
• emergency medical services
• out-of-network coverage