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For a year and a half now, the No Surprises Act has protected patients from some of the most outrageous out-of-network medical bills , a million times a month, according to one survey.

But Congress left something pretty crucial out of the law , bills from ground ambulances. 

We look at just how wild ambulance bills can be, with a story about three siblings who took identical ambulance rides , from the same car wreck to the same hospital , and got completely different bills. (Thanks to Bram Sable-Smith who reported the story for the Bill of the Month, a series from NPR and KFF Health News.). 

And we find out how ambulance bills ended up being so random , a story that takes us back to the 1970’s. 

We hear from Patricia Kelmar from PIRG, who lobbied for the No Surprises Act and continues to push for protections from surprise bills from ambulance rides.

Plus, what you can do if you get hit with an out-of-network ambulance bill:

  • See if you can negotiate a better deal
  • See if you might qualify for financial assistance. (Here’s some detailed guidance from Jared Walker of Dollar For.)
  • See if you’re protected under state law. At least 13 states have passed laws protecting some patients from surprise ambulance bills. Here, check to see if your state is one of them.

    Map of US showing 13 states with protections from surprise ambulance bills: Arkansas, Colorado, Delaware, Florida, Illinois, Louisiana, Maine, Maryland, New York, Ohio, Texas, Vermont, and West Virginia

    Map: Courtesy of PIRG (Public Interest Research Group), from https://pirg.org/edfund/resources/emergency-the-high-cost-of-ambulance-surprise-bills/ 

You’ll find more details on state laws in this report from the Commonwealth Fund.

Want to share your thoughts on how Congress should deal with out-of-network ambulance bills? A federal advisory committee wants to hear them. You can email them here.

Here’s a transcript of this episode

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