1. (a) Beginning in the year 2027, and in each year thereafter, an emergency medical service provider shall submit to the Alabama Department of Public Health a report that includes, but is not limited to, the following information for the preceding calendar year:

   1. (1) The number and type of emergency medical service vehicles that are in service.
   2. (2) The number of employees, both full-time and part-time, classified by position or emergency medical service provider license classification.
   3. (3) The total number of ground ambulance transports rendered.
   4. (4) The average response time for collecting and transporting a patient to a definitive care facility.
   5. (5) The gross income received by the emergency medical service provider in the State of Alabama and the net profit.
   6. (6) If the emergency medical service provider distributes ownership shares to the public, the number and amount of dividends issued.
   7. (7) For the calendar year 2027, the amount of receipts collected by the emergency medical service provider which are remitted to a parent entity, both before and after implementation of any change in payment or reimbursement by a health care insurer.
   8. (8) For the calendar year 2027, the amount paid or reimbursed to an emergency medical service provider by health care insurers, presented on a monthly or quarterly basis.

2. (b)

   1. (1) In the year 2027, a health care insurer shall submit to the Alabama Department of Public Health a report on claims for reimbursement submitted by emergency medical service providers which presents, for each of the three calendar years preceding January 1, 2027:

      1. a. The number of denied claims;
      2. b. The aggregate dollar value of denied claims;
      3. c. The percentage of denied claims to approved claims;
      4. d. The applicable out-of-pocket charge under each health care benefit plan issued by the health care insurer on an approved claim for covered services; and
      5. e. The total amount paid on claims for covered services, including in comparison to the total amount paid out on all claims for health care services.
   2. (2) Beginning in the year 2028, and in each year thereafter, a health care insurer shall submit to the Alabama Department of Public Health a report that includes, but may not be limited to, each item of information required under subdivision (1) for the preceding calendar year.
3. (c) The financial information required for submission under subsections (a) and (b) shall be confidential and may not be made public by the Alabama Department of Public Health or any contractor of the department.
4. (d) The Alabama Department of Public Health shall adopt rules to implement this section, and may prescribe reporting periods, deadlines, or formatting of information to be reported, and may require an emergency medical service provider or health care insurer to submit operational and financial data or information in addition to the information required under subsections (a) and (b).

(Act 2026-349, §4.)