Relating to consumer protections against certain medical and health care billing by emergency medical services providers.

Contracts

• Third-Party Billing (RCM) Vendors: Review Master Services Agreements immediately. You must add strong indemnification clauses holding vendors liable for defense costs and business interruption if their data entry errors trigger a DSHS licensure investigation.
• Payer Contracts: Ensure contracts do not contain fixed-rate language that conflicts with your statutory right to the annual inflation adjustment.

Hiring/Training

• Finance/Billing Staff: Staff must be trained on the new statutory formula for rate increases: the *lesser* of the Medicare Ambulance Inflation Factor or 10% of the previous year's rates.
• Compliance Officer: Designate a specific officer to review and sign off on all data transmitted to the TDI Balance Billing Rate Database. This is no longer a clerical task; it is a licensure-critical function.

Reporting & Record-Keeping

• Remediation Log: Create a permanent log of all inadvertent balance billing errors and the subsequent refunds/adjustments. This document will be your primary defense if DSHS alleges a "pattern of violations."
• Rate Calculation Audit Trail: Retain source documentation for the Medicare Inflation Factor used and prior year rate sheets to justify your submitted rate adjustments to TDI.

Fees & Costs

• Revenue Impact: Annual rate increases are now strictly capped. Budget forecasting must align with the Medicare Ambulance Inflation Factor or the 10% ceiling, whichever is lower.
• Liability Insurance: Review D&O and E&O policies to ensure coverage extends to regulatory licensure defense proceedings.