Ground ambulance advisory group

We were directed by the legislature to work with the Department of Health and the Health Care Authority to study how to prevent balance billing from ground ambulance services and to recommend whether or not these services should be subject to Washington's Balance Billing Protection Act. Our advisory group on this issue sent its recommendations to the legislature in October 2023. Legislation banning ground ambulance balance billing was enacted in 2024. 

Advisory group and report

• Presentation to the Washington State Senate Health & Long Term Care Committee – October 30, 2023 (PDF, 907.37 KB)
• Ground Ambulance Advisory Group members (PDF, 150.32 KB)
• Ground Ambulance Study Workplan (PDF, 137.11 KB)
• 2023 Ground ambulance balance billing report (PDF, 1.05 MB)
• Ground ambulance balance billing executive summary (PDF, 208.40 KB)

Advisory Group meetings

August 10 meeting materials

• August 10 meeting agenda (PDF, 200.50 KB)

Comments on policy options 

• Northwest Health Law Advocates ground ambulance billing recommendations letter (PDF, 775.62 KB)
• Washington Ambulance Association ground ambulance balance billing letter (PDF, 216.52 KB)
• Washington Fire Chiefs ground ambulance balance billing letter (PDF, 176.19 KB)
• Rhonda Holden ground ambulance balance billing letter (PDF, 98.01 KB)

July 26 meeting materials

• Northwest project presentation (PDF, 221.63 KB)
• Provider and carrier survey results presentation (PDF, 405.67 KB)
• Value and systems science lab presentation on EMS services (PDF, 673.57 KB)
• Value and systems science lab (VSSL) EMS service and vehicle license applications report (PDF, 955.82 KB)

June 15 meeting materials

• The No surprises act and state action to address ground ambulance bills presentation (PDF, 703.63 KB)

May 4 meeting materials

• May 4 meeting agenda (PDF, 126.77 KB)
• APCD analysis presentation (PDF, 1.60 MB)

March 31 meeting materials

• March 31 meeting agenda (PDF, 180.94 KB)
• Health Care Authority presentation (PDF, 639.95 KB)
• Office of Insurance Commissioner presentations (PDF, 856.40 KB)
• Systems Designs West presentation (PDF, 388.10 KB)
• University of Washington presentation (PDF, 470.80 KB)

February 27 meeting materials

• February 27 meeting agenda (PDF, 163.82 KB)
• Washington Ambulance Association presentation (PDF, 3.50 MB)
• Department of Health presentation (PDF, 910.96 KB)
• Association of Washington Cities presentation (PDF, 817.09 KB)
• Association of Washington Health Plans presentation (PDF, 121.42 KB)
• Washington Fire Chiefs presentation (PDF, 145.77 KB)

January 20 meeting materials

• Jan. 20 meeting agenda (PDF, 182.57 KB)
• Ground ambulance balance billing presentation (PDF, 498.15 KB)