A number of states across the country are looking to regulate air-ambulance services due to their steep costs, but the legal hurdles toward passing such rules continue to prevent any headway.
As the industry for air-ambulance services has grown, the complaints about the prices of such services and their lack of regulation have increased as well, an ABC News report confirms.
States that have attempted to set rules for air-ambulance services were met with lawsuits that assert that the aircraft (often helicopters) fall under the Airline Deregulation Act and thus cannot be subjected to regulation.
In 2015, legislators in North Dakota passed a bill that required air-ambulance services to be participating providers with insurance carriers that cover at least 75% of the state’s population for inclusion on a “primary call list.” Just last month, a federal judge ruled that the Airline Deregulation Act took precedence over the bill.
While the Airline Deregulation Act of 1978 was meant to enhance competition among airlines, reduce rates, and improve airline passenger service, the industry still had to recoup its high costs from among the limited number of flights they service. Thus, air ambulance services charge exorbitant prices for their flights.
In early April, U.S. Senators Jon Tester of Montana and John Hoeven of North Dakota proposed amendments to the Airline Deregulation Act to allow states to determine if they want to set down rules regulating air ambulance rates and services.
The effort failed, but a spokesperson for Tester confirmed that he will continue to work on the issue. The Montana Legislature's economic affairs interim committee is also looking into the issue, and plans to introduce a bill with a similar concept during its 2017 session.
The ABC News article also noted that patients “don't realize they should ask or might not be capable of asking whether their transportation is within their insurers’ networks or how much their insurance will cover.” Patients unable to raise their concerns could face large medical bills thanks to their use of an air ambulance that is not covered.
REACH Medical Services director of business development Don Wharton explained that the high prices bills “are a product of commercial insurance carriers and payers being unwilling to pay the fair market value for the service.”
Some for-profit air ambulance services even mentioned that Medicare reimbursements (both federal and state) are not enough to cover for the costs of the flights, so they have to charge some of their patients more.
Insurance carriers and employee benefit managers argued, however, that air ambulance companies do not reveal the actual costs of their services, thus preventing them from deciding on a fair payment.
Until a permanent solution to the high prices of air ambulance services is found, the National Association of Insurance Commissioners (NAIC) advises policyholders to fully understand their coverage, and to check if air ambulance flights are parts of the deal.
