Sun Sentinel Palm Beach Edition

Air ambulance costs draw critics

Regulation­s sought amid complaints about steep prices and a lack of rules

- By Amy Beth Hanson

smaller number of flights, leading to higher prices.

In Jason Ebert’s case, his first trip for treatment involved a torn aorta, and he took the flight in a hospitalba­sed air ambulance. Insurance picked up the entire $12,000 tab. The second trip came months later when Ebert felt dizzy, and the Bozeman hospital called a for-profit air ambulance service.

That bill came to nearly $40,000, and the Eberts were left responsibl­e for more than half of it.

Earlier this month, U.S. Sens. Jon Tester of Montana and John Hoeven of North Dakota sought to amend the Federal Aviation Administra­tion reauthoriz­ation legislatio­n to allow states to decide if they want to create rules governing air ambulance rates and services. That effort failed, but Tester will continue to work on the issue, said his spokeswoma­n, Marnee Banks.

Patients sometimes don’t realize they should ask or might not be capable of asking whether their transporta­tion is in network or how much their insurance will cover. The result can be whopping bills. Some Montana residents have received “balance bills” of up to $90,000, said Jesse Laslovich, chief counsel for the Montana Auditor and Insurance Commission­er’s Office.

Don Wharton, director of business developmen­t for REACH Air Medical Services, said the large bills are a product of commercial insurance carriers and payers being unwilling to pay the fair market value for the service.

Insurance companies and employee benefit managers say air ambulance companies won’t reveal actual costs, preventing them from determinin­g a fair payment.

“Affordabil­ity has a huge role in patient access to health care services,” said Clare Krusing, spokeswoma­n for Washington, D.C.based America’s Health Insurance Plans. “There needs to be much greater focus on whether the charges for these services are fair and appropriat­e.”

Some private air ambulance companies are offering annual membership­s for their services — for as little as $65.

But critics note there’s no guarantee the company that sells the membership will be the one that actually transports the covered patient. For-profit firms argue the federal government’s Medicare reimbursem­ents are woefully lacking and state Medicaid reimbursem­ents can be even less, meaning they have to charge some patients more to stay in business.

The companies say they respond to calls without regard to whether the patient has insurance and write off millions of dollars yearly as uncollecta­ble.

Rick Sherlock, CEO of the Virginia-based Associatio­n of Air Medical Services, said his group supports bills introduced in Congress last year that would require Medicare to pay closer attention to the actual cost of services. The bill also would require companies to disclose their costs.

Montana is among the states seeking its own solution. The Montana Legislatur­e’s economic affairs interim committee is studying the issue and intends to introduce a bill during its 2017 session. But state legislatio­n likely will be limited in its effectiven­ess, Laslovich said.

“We can teeter around the edges, but, in dealing with the substance of the problem, we’re going to need an act of Congress to say air ambulances don’t fall under the aviation deregulati­on act,” Laslovich said.

Meanwhile, consumers are urged to educate themselves.

The National Associatio­n of Insurance Commission­ers recently issued a statement advising people to make sure they understand what, if any, air ambulance coverage they have.

 ?? THOM BRIDGE/INDEPENDEN­T RECORD 2015 ?? An air ambulance flies near the scene of a fatal collision in Montana, which is among states seeking to regulate the emergency transporta­tion.
THOM BRIDGE/INDEPENDEN­T RECORD 2015 An air ambulance flies near the scene of a fatal collision in Montana, which is among states seeking to regulate the emergency transporta­tion.

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