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Alabama SB269 - Ground Ambulance Balance Billing Prohibition

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Published April 6th, 2026
Detected April 7th, 2026
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Summary

Alabama enacted Senate Bill 269 prohibiting ground ambulance balance billing and establishing minimum reimbursement rates that health insurers must pay to emergency medical service providers. The legislation sponsored by Senator Bobby Singleton passed with strong bipartisan support, clearing the House 101-0 and the Senate 25-2. The bill affects health insurance companies operating in Alabama and EMS providers serving patients with commercial insurance coverage.

What changed

Alabama enacted SB269, which prohibits balance billing by ground ambulance service providers for patients with commercial health insurance, a practice where patients are billed for the difference between provider charges and insurer payments. The law also establishes minimum reimbursement rates that health insurers must pay to emergency medical service providers for emergency ground ambulance services. Health insurers operating in Alabama must now ensure their reimbursement policies for ground ambulance services meet the mandated minimum rates. Emergency medical service providers will benefit from guaranteed minimum payments, reducing disputes over out-of-network claims and improving revenue stability.

What to do next

  1. Health insurers should review and update reimbursement policies to comply with new minimum rates for ground ambulance services
  2. EMS providers should understand their rights to receive minimum reimbursement from health insurers
  3. Monitor for additional implementing regulations or guidance from Alabama insurance regulators

Source document (simplified)

ChangeBridge / Alabama / SB269 Enacted SB269 Senate Bill Enacted 2026-04-06

Ground ambulance services; to prohibit balance billing and set minimum reimbursement rates by health care insurers to emergency medical service providers

Bill Details

State Alabama

Session 2026 Regular Session

Chamber Senate

Official Source alison.legislature.state.al.us/bill-search

LegiScan View on LegiScan

Sponsors

Bobby Singleton (Sen - D)

Action History

2026-04-06 S Enacted 2026-04-06 S Enacted 2026-03-31 S Delivered to Governor 2026-03-31 H Signature Requested 2026-03-31 S Enrolled 2026-03-31 S Ready to Enroll 2026-03-31 H Motion to Read a Third Time and Pass - Adopted Roll Call 1066 2026-03-31 H Third Reading in Second House 2026-03-17 H Read for the Second Time and placed on the Calendar 2026-03-17 H Reported Out of Committee Second House 2026-03-05 H Pending House Insurance 2026-03-05 H Read for the first time and referred to the House Committee on Insurance 2026-03-03 S Engrossed 2026-03-03 S Motion to Read a Third Time and Pass as Amended - Adopted Roll Call 683 2026-03-03 S Singleton motion to Adopt - Adopted Roll Call 682 XD1P9Z7-1 2026-03-03 S Banking and Insurance 1st Substitute Offered XD1P9Z7-1 2026-03-03 S Third Reading in House of Origin 2026-02-26 S Read for the Second Time and placed on the Calendar 2026-02-26 S Reported Out of Committee House of Origin 2026-02-26 S Banking and Insurance 1st Substitute XD1P9Z7-1 2026-02-05 S Pending Senate Banking and Insurance 2026-02-05 S Read for the first time and referred to the Senate Committee on Banking and Insurance

Votes

2026-03-03 SBIR: Passed by House of Origin Yea: 25 Nay: 2 2026-03-03 Third Reading in House of Origin Yea: 25 Nay: 2 2026-03-03 Singleton motion to Adopt - Roll Call 682 XD1P9Z7-1 Yea: 25 Nay: 1 2026-03-03 Motion to Read a Third Time and Pass as Amended - Roll Call 683 Yea: 26 Nay: 2 2026-03-31 HBIR: Passed by Second House Yea: 101 Nay: 0 2026-03-31 Third Reading in Second House Yea: 101 Nay: 0 2026-03-31 Motion to Read a Third Time and Pass - Roll Call 1033 Yea: 91 Nay: 3 2026-03-31 HBIR: Passed by Second House Yea: 102 Nay: 0 2026-03-31 Motion to Read a Third Time and Pass - Roll Call 1066 Yea: 103 Nay: 0

Committee Referrals

2026-02-05 S Banking and Insurance 2026-03-05 H Insurance

Amendments

2026-02-26 Senate Banking and Insurance Banking and Insurance 1st Substitute

Bill Text Versions

2026-02-05 Introduced 2026-03-03 Engrossed 2026-03-31 Enrolled

Subjects

Insurance Legislative data powered by LegiScan (CC BY 4.0)

Source

Analysis generated by AI. Source diff and links are from the original.

Classification

Agency
Alabama Legislature
Published
April 6th, 2026
Instrument
Rule
Legal weight
Binding
Stage
Final
Change scope
Substantive
Document ID
SB269 (2026 Regular Session)

Who this affects

Applies to
Insurers Healthcare providers
Industry sector
5242 Health Insurance
Activity scope
Health insurance reimbursement Emergency medical services
Geographic scope
US-AL US-AL

Taxonomy

Primary area
Healthcare
Operational domain
Compliance
Topics
Insurance

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