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Home , David Jolly, Gwen Graham, John Mica

ADVOCACY ALERT: AIR AMBULANCE

 The recently passed HB 221 does not address emergency ground transportation or emergency air ambulance services. Air ambulance providers were specifically carved out of the legislation prohibiting balance billing because of current federal pre-emption regulations on price, routes and services.

 High bills to consumers often come from air ambulance companies that are not affiliated with a hospital and are not in a carrier network.

 The National Association of Insurance Commissioners (NAIC) is currently pursuing a fix to federal legislation that will address air ambulance rates and services allowing them to be regulated at the state level. The U.S. Senate is currently considering amendments to the FAA Reauthorization bill sponsored by Senators Hoeven (R-ND) and Tester (D-MT).

 Some state regulators have been successful in facilitating contract negotiations between air ambulance companies and insurers to assure consumers pay in-network rates for services. Additionally, many states have held hearings on air transportation issues to address consumer impact.

Quick Facts  Factors determining the final cost of an air flight are: 1) distance flown, 2) type of aircraft used, 3) current cost of jet fuel, and 4) medical needs of the patient in flight.

 The Association of Air Medical Services asserts that the cost of an air flight considers specialized labor (24-hour medical staff available), training, equipment, and fuel; it is necessary to maintain readiness to respond 24 hours a day, seven days a week, 365 days a year.

 According to the NAIC, the average air ambulance trip is 52 miles and costs between $12,000 to $25,000 per flight. The Air Charter Guide reports that the average cost to rent a Boeing 737 is between $12,000 to $15,000/hour.

 FAIR Health, Inc., an independent nonprofit, which owns a national private claims database, reports that in the last two years, consumers with healthcare insurance were charged on average $15,299.03 for a one-way rotary wing vehicle flight in addition to a per mile charge of $470.27.

 Air Methods, an air ambulance provider, has reported that the average insurance company covers more than 80% of charges for Florida consumers. Blue Cross/Blue Shield is said to only cover 57% of the charges.

Florida Stories  A consumer who suffered a heart attack was air lifted from Okeechobee to Ft. Pierce (approximately 32 miles). The bill for the consumer’s air ambulance trip was $43,049.28, of which $31,091.20 was a flat rate charge for the flight and $11,958.08 was charged for mileage. The consumer appealed and his healthcare eventually covered the bill except for his $1,000 co-pay.

 A consumer was transported from Lake City Medical Center to North Florida Regional Medical Center in Gainesville, Florida (approximately 45 miles). The bill from the air ambulance company was $36,234.49. The healthcare plan paid $5,915.50 and the consumer was balance billed $30,335.56.

 A retired Florida resident was transported by air ambulance from Vero Beach to Ft. Pierce. The consumer was flat rate charged $20,048.74 for the flight and $5,338.44 for the 18 mile trip. The healthcare plan paid $4,821.19 of the bill. The consumer stated that the air ambulance service asked for a complete list of assets and bank accounts and advised her to take out a mortgage to pay the remainder of the bill.

Advocacy Strategy Reach out to Florida’s Congressional delegation to support NAIC language before the first committee meets in June.

Florida Representatives Florida Senators (R) (R) (D) (D) (R) (R) (R) Jeff Miller (R) (D) Patrick Murphy (D) Curtis Clawson (R) Richard Nugent (R) (R) (R) (R) Thomas Rooney (R) Ron DeSantis (R) Ileana Ros-Lehtinen (R) Theodore Deutch (D) (R) Mario Diaz-Balart (R) (D) (D) Daniel Webster (R) (D) (D) (D) (R) (D)

Cited References: Fair Health, Inc. http://www.nytimes.com/2015/05/06/business/rescued-by-an-air-ambulance-but-stunned-at-the-sky-high-bill.html?_r=0 http://www.theatlantic.com/health/archive/2016/01/air-ambulance-helicopter-cost/425061/ http://health.costhelper.com/air-ambulances.html http://wjhg.com/home/headlines/85584502.html