ESHB 1187
SignedHouse
Delayed ambulance bills
Protecting patients involved in motor vehicle accidents from delayed ambulance bills.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill requires ambulance services to collect insurance information from patients involved in motor vehicle accidents and to provide them with a clear notice explaining how their ambulance bills may be covered by different types of insurance. It also mandates the creation of a standardized consumer education notice to help patients understand their coverage options and rights.
- Ambulance services must try to collect automotive, health, or personal injury insurance information from patients during transport for accidents involving motor vehicles (including pedestrians or cyclists struck by vehicles).
- Ambulance services must provide patients with a standardized consumer notice at the time of transport or within 60 days of transport, explaining insurance coverage options and billing procedures.
- Within 60 days of transport, ambulance services must either bill the patient’s insurance (if collected at transport) or attempt to collect insurance info and bill within that 60-day window.
- The Washington State Department of Health, in consultation with the Office of the Insurance Commissioner and other stakeholders, must develop a standard consumer notice by January 1, 2026, to help patients understand how their ambulance bills may be covered after a motor vehicle accident.
Who is affected
- Patients involved in motor vehicle accidents — Patients who receive ambulance services after being involved in a motor vehicle accident (including pedestrians or cyclists struck by vehicles) may be required to provide insurance information at the time of transport or shortly after, and must receive clear information about how their ambulance bill may be covered.
- Ambulance service providers — Ambulance service providers must collect insurance information from patients at the time of transport or within 60 days, and provide them with a standardized notice about insurance coverage options and billing procedures.
- Insurance companies — Insurance companies (including auto, health, and personal injury insurers) may see changes in how and when they receive claims for ambulance services related to motor vehicle accidents.
- State agencies (Department of Health and Office of the Insurance Commissioner) — The Washington State Department of Health and the Office of the Insurance Commissioner must collaborate to develop and distribute a standardized consumer notice about insurance coverage for ambulance bills.
Pro/Con Analysis
Potential Benefits (5)
The standardized consumer notice and requirement to provide it at transport or within 60 days improves patient awareness of insurance coordination rules (e.g., auto vs. health vs. PIP coverage), empowering patients to challenge incorrect billing and assert their rights—reducing surprise bills and billing confusion.
Rights & LibertiesPeopleRef: Sec. 1(1)(b), Sec. 1(2)(a), Sec. 2By requiring ambulance services to collect insurance information at the scene or within 60 days, the bill increases the likelihood that claims are submitted to the correct insurer first—reducing patient delays, denials, and out-of-pocket costs that often arise when billing goes to the wrong payer (e.g., health insurance instead of auto PIP).
FinancialPeopleRef: Sec. 1(1)(a), Sec. 1(2)(b)(i)The standardized consumer notice, developed with stakeholder input, will clarify how insurance layers apply after motor vehicle accidents—helping patients understand why they may receive bills from multiple insurers and how to coordinate claims, especially for non-English speakers or those with low health literacy.
EducationPeopleRef: Sec. 2Clearer insurance coordination may reduce administrative delays in care follow-up—e.g., patients won’t need to separately contact insurers or providers to determine who paid or why they received a bill, allowing clinicians to focus on recovery rather than billing logistics.
HealthcarePeopleRef: Sec. 1(1)(a), Sec. 1(2)(b)(i)Expanding the definition of “motor vehicle accident” to include pedestrians and cyclists struck by vehicles ensures that vulnerable road users receive the same billing protections—potentially reducing disparities in care access for non-drivers.
Public SafetyLean peopleRef: Sec. 1(1)(a)
Potential Concerns (5)
Ambulance providers must collect insurance information from patients during or shortly after transport, which may delay care or create stress for patients who are injured, in shock, or unable to recall insurance details—potentially leading to billing errors, delayed claims processing, or unexpected out-of-pocket costs if insurance information is incomplete or miscollected.
FinancialPeopleRef: Sec. 1(1)(a), Sec. 1(2)(b)(ii)The 60-day window for billing insurance increases administrative burden on patients who must follow up on claims, dispute errors, or navigate complex insurance coordination rules—particularly burdensome for low-income, elderly, or non-English-speaking patients with limited access to support.
FinancialLean peopleRef: Sec. 1(2)(b)(i), Sec. 1(2)(b)(ii)The bill does not address upstream safety concerns—such as preventing motor vehicle accidents or ensuring ambulances are staffed and equipped appropriately—so while it improves billing transparency, it does not improve the underlying public safety risks that lead to ambulance use.
Public SafetyLean peopleRef: Sec. 2 (consumer notice development)Requiring ambulance staff to collect insurance information during or after emergency transport may divert clinical staff time from patient care during critical minutes—especially in rural or understaffed services—potentially compromising care quality or response times.
HealthcareLean peopleRef: Sec. 1(1)(a), Sec. 1(2)(b)(ii)Patients without insurance or with incomplete coverage may still be billed directly after 60 days, and the bill does not cap out-of-pocket costs or provide financial assistance—leaving vulnerable patients (e.g., low-income, undocumented, or underinsured) exposed to surprise medical debt despite the notice.
FinancialPeopleRef: Sec. 1(2)(b)(ii)
Who Is Most Affected
Patients involved in motor vehicle accidents—especially those with auto, health, or PIP coverage—will benefit from clearer billing processes and reduced surprise bills, but low-income, underinsured, or non-English-speaking patients may still face financial strain due to lack of cost caps or financial assistance.
Ambulance service providers will face new administrative duties (collecting insurance info, delivering notices), which may increase operational costs—especially for small or rural providers—but may also reduce billing delays and denials if insurance is correctly identified upfront.
Insurance companies (auto, health, PIP) will receive more accurate and timely claims, potentially reducing administrative overhead—but may also face increased scrutiny over coordination of benefits and potential disputes over which insurer is primary.
State agencies (DOH and OIC) will incur modest administrative costs to develop and distribute the standardized notice, but this is a one-time cost with long-term public benefit—no major fiscal burden is projected in the bill text.
Hospitals and emergency departments may benefit indirectly as patients arrive with clearer billing information, reducing downstream disputes—but they are not directly regulated by this bill.