Va. committee hears emotional testimony on NEMT surprise bills; lawmakers take HB 1115 "by for the day"

The House Committee on Health and Human Services on Wednesday heard extended testimony on HB 1115, a bill from Delegate Navarre that would require nonemergency medical transportation (NEMT) providers to disclose upfront written fees, and then voted to take the bill "by for the day" to allow further drafting.

Delegate Mayne Navarre, the bill’s patron, described the measure and a substitute that narrows the disclosure duty when a state medical-assistance plan (for example, Medicaid) covers the service, saying the substitute “clarifies that disclosure isn't required when a state medical assistance plan like Medicaid or Medicare covers the service simply because those patients have no out of pocket costs.” Navarre told the committee the bill is intended to give patients clear written notice of total out-of-pocket charges and examples of reasonable methods for disclosure such as a website rate sheet, brochure or invoice.

A Virginia parent who identified herself as Misty and said she is a constituent of the bill’s patron gave emotional testimony about a pediatric interfacility transfer. She said, “In April my son required interfacility ambulance transfer … we received a bill that was an estimate of $22,700,” and that after insurance payments she was left with what she described as “a little over $2,100” to pay. The amounts she recounted do not add arithmetically in the testimony provided to the committee; she said $500 was covered by insurance but the numbers reported in testimony are internally inconsistent.

Ed Rhodes, speaking for the Virginia Ambulance Association, thanked the patron for meeting with the industry but warned the committee that the current draft could put families in a position where they must weigh obtaining necessary higher-level care against facing significant financial burden. Dr. Sheila Furey, a medical provider, also raised a concern that excluding covered services from disclosure could create incentives for fee inflation by providers and insurers.

After questions from members about how the bill would apply to recurring transports such as dialysis and whether hospitals typically offer multiple contracted providers, a committee member moved to take the bill "by for the day" to allow more stakeholder work; the motion was seconded and approved by voice vote. Chair Delegate Rodney Willard thanked the patron and said he expects additional drafting before the bill returns to committee.

The committee did not reach a final vote on HB 1115; members asked counsel and the patron to refine statutory language, clarify whether disclosures must be made for recurring arrangements and ensure the substitute’s ‘‘reasonably expected’’ methods of notice would cover practical rate-sheet approaches.

The bill’s principal advocates urged the measure as a transparency fix to prevent surprise charges. Industry witnesses said they are willing to continue talks but asked for more time to resolve implementation details.

What’s next: HB 1115 was taken "by for the day" for further work; no final committee passage was recorded at this meeting.