The No Surprises Act may be reducing the amount of "surprise billing" patients face when they encounter an out-of-network provider in an in-network facility, but there's one area where the law's effects don't reach: ground ambulances.

The law, signed in December 2020 by President Trump, exempts patients from having to pay out-of-network charges under certain circumstances, such as when they are transported to an out-of-network hospital during an emergency, or when they unexpectedly get a service such as anesthesia from an out-of-network provider at their in-network hospital. In those situations, health insurers are allowed to bill patients only the in-network charge, if there is one, and the insurer then negotiates what it will pay to the out-of-network provider; if the provider and insur

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