To be air-lifted from one healthcare facility to another, or from an accident site to a hospital, is often a vital, life-saving measure that is necessary for the patient. Unfortunately, that life-saving helicopter ride can be extremely costly, since air ambulances are exempt from healthcare billing regulations. Congress is looking to fix this.
It’s a regulatory blind spot, and it can cost patients thousands.
“Last November, a fully insured North Dakotan was dispatched on an 84-mile medical air transport from Langdon, N.D., to Grand Forks. When the charges came in at more than $66,000, out-of-network insurance covered just $16,000.
The patient was left with a $50,000 bill balance from Valley Med Flight. The tab far exceeded the $29,000 to $30,000 average price for a cross-country charter flight on a private midsize jet from Virginia to Oregon—according to an informal estimate by the charter company EvoJets.
According to tallied complaints lodged with the state's insurance department and provided by Blue Cross and Blue Shield of North Dakota, surprise charges for various medical flights from the past four years ranged from $26,000 to nearly $534,000—although the latter number is a major outlier. Most charges fell between $30,000 and $88,000, with the average hovering around $60,000.”
Talk about a surprise bill! Air ambulances that are out of a patient’s insurance network mean that the patient is responsible for a large chunk of the bill. While many individual states have tried to regulate air ambulances, all have lost in court. Federal action is needed to find a solution.
HealthLeaders reports that with the frustrations growing among Americans who are being charged exorbitant prices for medical treatment, a bipartisan group of senators unveiled a plan to protect patients from surprise bills and high charges from out-of-network sources.
The draft legislation is designed to prevent medical bankruptcies from things like treatment for an emergency by a doctor who is not part of the patient’s network or treatment received at an out-of-network hospital. Patients who are air-lifted from accident sites run the risk of being taken to a hospital that is out-of-network for their plan. This starts a chain of bills that can lead to bankruptcy.
There is currently no cap on pricing or costs on air ambulances, and prices reflect that. State Impact Oklahoma reports that Air Methods, the largest air ambulance company in the country, shows a dramatic rise in price in recent years.
“A Government Accountability report found that between 2007 and 2016, Air Methods’ average helicopter transport costs increased from $13,000 to $49,800. Since it owns two-thirds of the air ambulances in the country, the company’s pricing greatly influences the market.
Because air ambulance providers accept much lower reimbursement rates from Medicare and Medicaid patients — and may not receive any payment at all from uninsured patients — the impact of these rate hikes has fallen almost entirely on private healthcare insurers and their members.”
Greg Hildenbrand, executive director of Life Star of Kansas, a non-profit air ambulance service and board member of the Association of Critical Care Transport, and a 20-year veteran of the industry, told State Impact Oklahoma that insurance companies are fed up.
‘‘I think we’ve reached a tipping point in the industry where insurance companies are saying, ‘No, we’re not going to continue to pay these rates,’ and so then patients get balance billed $40,000 or something after their insurance has paid. I don’t think it’s a sustainable system,’ he said.”
At NCCFH, we’re not a fan of surprise bills. Paired with the new draft legislation that hopes to eliminate surprise charges, there are other legislative bills that focus solely on the complex needs of regulating air ambulances.
State Impact Oklahoma continues:
“The FAA reauthorization bill recently passed by the U.S. House of Representatives includes some important consumer protections. Right now, patients get one big bill for services. The legislation under consideration would require itemized bills that separate out transportation and medical charges.
… The House version of the FAA reauthorization bill would also set up a council of industry representatives, lead by the Department of Transportation, which oversees air ambulances. The group would include air ambulance providers and insurance company representatives, among others, and would write and reevaluate consumer protections. The legislation also establishes a complaint hotline for patients, similar to one available for commercial airline passengers.
…Congressional Republicans and Democrats are backing other bills to give consumers more protections in the event air medical reforms are stripped from the FAA legislation. Whether these efforts lead to lower air ambulance costs for patients is up in the air.”
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