Wednesday, November 13, 2019

Congress aims to curb surprise air ambulance bills

Use of air ambulances has declined over the past decade, and prices for their runs have soared, so many customers are stuck with massive, unexpected bills when their insurance fails to cover the ride. Complaints from constituents have prompted lawmakers at both the state and federal level to try to curb the surprise bills, Alma Almendrala reports for NPR.

An estimated one in six insured Americans are hit with surprise bills after a hospital stay, and air ambulances are a big offender. Tom Saputo, of Thousand Oaks, Calif., ended up paying more for a post-surgical ride back to the hospital than he did for the surgery itself, a double lung transplant. The air ambulance company, Mercy Air, charged his insurance company more than $51,000 for the 27-mile flight, leaving Saputo responsible for more than $11,000, Almendrala reports. Mercy Air blamed Saputo's insurer for not covering more of the bill, but forgave the bill after it caught the attention of ABC's "Good Morning America."

"The median cost of a helicopter air ambulance flight was $36,400 in 2017, an increase of more than 60 percent from the median price in 2012, according to a Government Accountability Office analysis. Two-thirds of the flights in 2017 were out of network, the report found," Almendrala reports. "The air ambulance industry justifies these charges by pointing out that the bulk of its business — transporting patients covered by the public insurance programs Medicare and Medicaid — is underfunded by the government."

Critics argue that market saturation is the real reason behind increasing air ambulance prices. "While the number of air ambulance helicopters in the U.S. has increased — rising more than 10% from 2010 to 2014 — the number of flights hasn't, which means air ambulance companies seek to raise prices on each ride," Almendrala reports.

State-level efforts to eliminate or limit surprise "balance billing," as it is called, have been generally unsuccessful; federal judges usually strike down such laws because they violate the Airline Deregulation Act of 1978, which prohibits states from regulating air traffic. Congress is considering several bills to limit or ban balance bills. "One measure by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., would ban balance bills from air ambulance companies," Almendrala reports. "The bill passed committee and is now headed to the Senate floor for a vote, pending approval from Senate Majority Leader Mitch McConnell of Kentucky."

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