Guardian Flight V. Godfread

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Guardian Flight V. Godfread Nos. 19-1343, 19-1381 IN THE UNITED STATES COURT OF APPEALS FOR THE EIGHTH CIRCUIT GUARDIAN FLIGHT, LLC, Plaintiff-Appellant/Cross-Appellee, v. JON GODFREAD, in his capacity as North Dakota Insurance Commissioner; WAYNE STENEHJEM, in his capacity as North Dakota Attorney General, Defendants-Appellees/Cross-Appellants. On Appeal from the United States District Court for District of North Dakota District Court No. 1:18-cv-007 BRIEF OF AMERICA’S HEALTH INSURANCE PLANS AS AMICUS CURIAE IN SUPPORT OF APPELLEES/CROSS-APPELLANTS Julie Simon Miller Hyland Hunt Thomas M. Palumbo Ruthanne M. Deutsch AMERICA’S HEALTH INSURANCE PLANS DEUTSCH HUNT PLLC 601 Pennsylvania Ave. NW 300 New Jersey Ave. NW South Building, Suite 500 Suite 900 Washington, DC 20004 Washington, DC 20001 Tel.: 202-868-6915 Fax: 202-609-8410 Email: [email protected] Attorneys for Amicus Curiae America’s Health Insurance Plans CORPORATE DISCLOSURE STATEMENT Under Rule 26.1 of the Federal Rules of Appellate Procedure, amicus curiae America’s Health Insurance Plans, Inc. (AHIP) submits the following corporate disclosure statement: AHIP has no parent corporation and no publicly-traded company holds 10% or more of AHIP’s stock. AHIP is a trade association whose members have no ownership interests. i TABLE OF CONTENTS CORPORATE DISCLOSURE STATEMENT .......................................................... i TABLE OF AUTHORITIES ................................................................................... iii STATEMENT OF INTEREST OF AMICUS CURIAE ............................................. 1 INTRODUCTION AND SUMMARY OF ARGUMENT ........................................ 2 ARGUMENT ............................................................................................................. 7 State Regulation Is Needed To Enhance Insurance Providers’ Ability To Protect Consumers From High Costs And Better Facilitate Access To Air Ambulance Services. .................................................................................................. 7 A. Air Ambulances Presently Operate in a Regulatory Vacuum. ................... 8 1. Competitive forces do not meaningfully constrain air ambulance pricing. ............................................................................. 8 2. Virtually all state efforts to regulate any aspect of insurance touching on air ambulances have been rebuffed. ............................. 12 B. The Regulatory Vacuum Has Resulted in Unconstrained Air Ambulance Pricing and Consumer Harm ................................................ 14 1. Air ambulance providers have largely refused to participate in health plan networks. ........................................................................ 15 2. The ability to send surprise medical bills and the lack of pricing transparency tip the scales of post-service negotiations in favor of exceptionally high bills for air ambulance services. .................... 21 3. Air ambulances’ refusal to participate in networks and heightened post-service leverage has resulted in skyrocketing costs for insurance providers and consumers. ................................. 24 CONCLUSION ........................................................................................................ 29 CERTIFICATE OF COMPLIANCE CERTIFICATE OF SERVICE ii TABLE OF AUTHORITIES CASES ...................................................................................................................... Page(s) Frye v. Kansas City Missouri Police Dept., 375 F.3d 785 (8th Cir. 2004)) ............ 14 Rowe v. N.H. Motor Transp. Ass’n, 552 U.S. 364 (2008) ....................................... 11 Valley Med Flight, Inc. v. Dwelle, 171 F. Supp. 3d 930 (D.N.D. 2016) .......... 12, 22 STATUTES Airline Deregulation Act of 1978, Pub. L. No. 95-504, § 3, 92 Stat. 1705 ............. 11 FAA Reauthorization Act of 2018, Pub. L. No. 115-254 § 418(a) ................................................................................................................. 13 § 418(b)(3)(B) ....................................................................................................... 13 § 418(d)(3) ............................................................................................................ 13 42 U.S.C. § 18022(b)(1)(B) ................................................................................................... 18 § 18031(c)(1)(B) ................................................................................................... 16 N.D.C.C. § 26.1-47-09(3) ................................................................................... 3, 34 REGULATIONS 45 C.F.R. 147.138(b)(3)(i)(A) ................................................................................. 22 OTHER AUTHORITIES AHIP, Center for Policy and Research, Charges Billed by Out-of-Network Providers: Implications for Affordability (Sept. 2015) ................................. 16, 21 AHIP, State Policy Issue Brief: Air Ambulance Services (2016) ................. 9, 20, 26 AHIP, What’s the Role of Networks in Providing High-Quality Affordable Care? .................................................................................................. 16 ConsumersUnion, Up in the Air: Inadequate Regulation for Emergency Air Ambulance Transportation (Mar. 2017) ................................................................ 9 Peter Eavis, Air Ambulances Offer a Lifeline, and Then a Sky-High Bill, N.Y. TIMES (May 5, 2015) ..................................................................................... 24, 27 iii Cindy Galli et al., Sky-Rage: Bills, Debt, Lawsuits Follow Helicopter Medevac Trips, ABC NEWS (Mar. 16, 2016) ................................................................ 25, 27 Sarah Gantz, Sky high air ambulance bills leave patients seeking relief, BALT. BUS. J. (Aug. 28, 2015) ................................................................................................. 24 Kaiser Family Foundation, Private Insurance: Surprise Medical Bills (Mar. 2016) ........................................................................................................... 21 Alison Kodjak, Taken for a Ride, NPR (Sept. 25, 2018) ......................................... 26 Md. Health Care Comm'n, Air Ambulance Study Required Under Senate Bill 770 (Dec. 2006) .................................................................................................... 17, 20 Mo. Dep’t of Ins., Fin. Institutions & Prof. Registration, Policy Brief: Health Coverage for Air Ambulance Transport .................................................. 10, 20, 27 Mont. State Leg., Final Report of the 2015-2016 Economic Affairs Interim Committee (May 2017) ................................................................................. 26, 27 N.M. Office of Superintendent of Ins., Air Ambulance Memorial: Study Report (Jan. 2017) ............................................................................................................ 25 Nat’l Conference of Ins. Legislators, Air Ambulance Task Force, Draft Minutes (July 15, 2017) ............................................................................................... 11, 22 Nat’l Conference of State Legislators, Insurance Carriers and Access to Healthcare Providers: Network Adequacy (Nov. 2015) ...................................... 16 Eric S. Peterson & Brian Maffly, Sky’s the Limit for What Utah Air Ambulances Can Charge—Like the $46K Bill This Man Received for a 50-mile Trip, SALT LAKE TRIB. (Aug. 29, 2016) ................................................................................. 27 PHI, Inc., Annual Report (Form 10-K) (Feb. 23, 2018) .......................................... 18 Patrick A. Rivers & Saundra H. Glover, Health care competition, strategic mission, and patient satisfaction: research model and propositions, 22 J. HEALTH ORGANIZATION MGMT. 627 (2008) ........................................................ 16 U.S. GOV’T ACCOUNTABILITY OFFICE, GAO-10-907, AIR AMBULANCE: EFFECTS OF INDUSTRY CHANGES ON SERVICES ARE UNCLEAR (2010) .................................... 18 U.S. GOV’T ACCOUNTABILITY OFFICE, GAO-17-637, AIR AMBULANCE: DATA COLLECTION AND TRANSPARENCY NEEDED TO ENHANCE DOT OVERSIGHT (2017) ............................................................................................................ passim U.S. GOV’T ACCOUNTABILITY OFFICE, GAO-19-292, AIR AMBULANCE: AVAILABLE DATA SHOW PRIVATELY-INSURED PATIENTS ARE AT FINANCIAL RISK 7 (2019) ......................................................................................................... passim iv STATEMENT OF INTEREST OF AMICUS CURIAE1 America’s Health Insurance Plans (AHIP) is the national trade association representing the health insurance provider community. AHIP advocates for public policies that expand affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality, and innovation. Along with its predecessors, AHIP has more than 60 years of experience in the industry. AHIP’s members provide health care coverage and other financial health and wellness benefits through employer-provided coverage, the individual insurance market, and public programs such as Medicare and Medicaid. As a result, AHIP’s members have broad experience working with a variety of stakeholders to ensure that patients have access to needed treatments and medical services at affordable prices. Those stakeholders include hospitals, physicians, clinics and laboratories, medical transportation providers
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