Study that showed increasing air-ambulance charges may bolster Senate bill that cracks down on surprise medical bills

In 2016, nationwide median charges for air ambulance services, which are used disproportionately in rural areas, were 4.1 to 9.5 times what Medicare paid for the same services, according to a recently published study. The billing disparity is much higher than for physicians or ground ambulance services. "Median charges for air ambulance services compared to Medicare rates soared by 46% to 61% from 2012 to 2016," Harris Meyer reports for Modern Healthcare. "For Medicare patients, the median charge per trip increased from $24,000 to $39,000."

Since many air ambulance providers aren't in insurance networks, patients get stuck with unexpected "balance bills" for thousands (or tens of thousands) of dollars for services they believed were in-network. The study may bolster a new Senate bill that would crack down on surprise bills. "Last month, the Senate health committee shocked the air ambulance industry, which is made up heavily of private equity-owned companies, by including a balance-billing ban for air ambulance services in its broader legislation to regulate surprise out-of-network billing," Meyer reports.

Because of a federal law that governs air carriers, courts have blocked states from regulating air ambulances, so experts say only the federal government can address the problem. "Congress last year ordered creation of an advisory committee of stakeholders to examine air ambulance price-transparency measures and consumer protections against excessive charges," Meyer reports.

"The Association of Air Medical Services, the industry's lobbying group, blamed inadequate Medicare and Medicaid payment rates for the out-of-network billing controversy," Meyer reports. "It said air ambulance services are essential for Americans, particularly in rural areas, and that the federal government needs to conduct a study to develop rates that cover actual costs in order to preserve these services."