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Thursday, October 24, 2019

Air ambulance bills may not be getting enough attention in Congressional crackdown on surprise bills

Are air ambulances' surprise bills being overlooked? That's what Karan Chabra, Kevin Schulman and Barak Richman argue at Health Affairs' blog, saying that air ambulance bills — which are frequently out of network — aren't getting enough attention amid the bigger crackdown on surprise bills.

"The air ambulance business model does not rely on a new technology or providing a valuable service," the authors write. "[I]nstead, it rests upon a carefully devised legal strategy that exploits the basic charge model in health care and then hides behind a legal loophole."

States can't regulate air ambulances because the industry falls under the purview of the Federal Aviation Administration. Congress formed a committee last year to look into air ambulance bills, which hurt rural residents the most.

Air ambulance lobbyists protest that legislations aimed at protecting consumers from surprise bills could cost rural residents access to their services, Liz Carey reports for The Daily Yonder. Dark money sources have shelled out millions of dollars for ads designed the kill the legislation.

Dwindling emergency services is an undeniable concern in rural areas, which have fewer hospitals and less access to road ambulance services. Rural ambulance services "are closing in record numbers, putting around 60 million Americans at risk of being stranded in a medical emergency," Erika Edwards reports for NBC News. "Because so many emergency medical services agencies have been struggling financially, some states are stepping in with funding. But emergency medical experts say it’s not enough to cure the dire situation."

The lack of access to ground services makes rural areas the main customers for air ambulances; about 90% of the industry's customers are rural, Carey reports. But rural residents may be paying surprise air ambulance bills for a while, according to the Health Affairs blog: "recent headlines suggest that federal legislative momentum has stalled, despite an initial surge of bipartisan interest."

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