Sunday, September 16, 2018

Your Opinion: Private insurers should cover air ambulance transports

I’d like to set the record straight on a recent article about air ambulance balance billing (Wicker, McCaskill seek answers on air ambulances – Sept. 11, 2018).

Balance billing (air ambulance or otherwise) occurs when an insurer passes the costs of healthcare on to the insured beneficiary. Everyone agrees that patients should not be stuck in the middle between an air ambulance company that saved their life and their insurance company. Rather, private insurance ought to cover emergency air ambulance transport, which is only deployed by a first responder or medical professional. When a medical helicopter is called, it goes, regardless of the patient’s ability to pay. If an insurance provider won’t cover an air ambulance transport that was considered medically necessary and requested by an independent medical professional, what’s insurance for?

States have the full authority to regulate the health care provided by medical helicopters. Senator McCaskill has proposed carving air ambulances out of the Airline Deregulation Act to allow states to expand regulation of the air ambulance industry. While I’m sure well-intentioned, this would in fact create borders in the sky, reducing access to these services, and would do nothing to lower costs for consumers.

Instead, private insurers should do right by air medical patients and cover air ambulance transports. Recently, Anthem Blue Cross Blue Shield Insurance in Missouri reached contract agreements with two air medical providers, Air Methods and Air Evac, to bring these services in network. Others should follow suit.

The air medical industry agrees strengthening Department of Transportation oversight and enforcement of air ambulance complaints is a good step but if policymakers really want to help consumers with transparency, they should pass the Ensuring Access to Air Ambulance Services Act. This legislation would modernize the outdated Medicare Air Ambulance Fee Schedule and require air medical providers to submit their cost data so Medicare can update its payment system to reflect the actual cost of providing care. As a result, financial pressures that drive balance billing would get relief and air medical providers will be able to ensure patients can continue to access this life-saving service.

Carter Johnson
SOAR Campaign, Washington, DC

Original article can be found here ➤

Wicker, McCaskill seek answers on air ambulances 

TUPELO • Sen. Roger Wicker has joined with Missouri’s Sen. Claire McCaskill in a bipartisan request for answers about billing abuses and oversight of air ambulance services.

The two senators sent a letter Friday to Secretary of Transportation Elaine Chao outlining concerns over possible consumer abuses and urging effective oversight.

The letter cites a report from the Government Accountability Office that found the median price charged by air ambulance providers went from about $15,000 to $30,000 between 2010 and 2014.

“Anecdotally, it is clear that a greater share of this cost is being passed along directly to consumers through a practice known as balance billing, but GAO was unable to determine the prevalence of this practice because of a lack of data,” the letter stated.

Balance billing is a practice where the patient is charged over and above what their health insurance deems reasonable and customary. The extra payments don’t count toward out-of-pocket maximums.

The Jackson-based Mississippi Health Advocacy Program has received a number of complaints from consumers who were asked to pay tens of thousands of dollars for air ambulance service after their insurance carriers had made payments.

“This is a good, practical first step,” said Roy Mitchell, Mississippi Health Advocacy Program executive director. “It’s great that Sen. Wicker is being responsive.”

Balance billing issues involving air ambulance services have been among the most troubling the health advocacy program sees, Mitchell said. Because they are called in life-threatening, emergency situations, customers have few options, if any.

In Mississippi, there is a law against balance billing on the books; however, air ambulances are not subject to the law.

“Many states have tried to address these costs and the practice of balance billing by treating the service like other health-care services,” the letter states. “However, the courts have consistently struck down these state laws citing the Airline Deregulation Act.”

The senators noted in the letter that the transportation department has begun collecting complaints about air ambulance services and making them public, a measure recommended by the GAO. Through July, there had been 16 complains logged for 2018. Mitchell said he believes the complaints in the federal database and those to his agency are the tip of the iceberg.

“The complaints don’t accurately reflect the problem because people don’t know where to turn,” Mitchell said.

The letter from Wicker and McCaskill asks questions about the department’s authority to investigate complaints and its ability to address the issue. The letter asks for responses by Sept. 28.

“This is an issue that not going to go away without some sort of consumer protection on a federal level,” Mitchell said.

Air ambulance providers have pushed back against efforts to add consumer protections and regulations, citing insufficient reimbursement from Medicare, Medicaid and some private insurers.

Original article can be found here ➤


Anonymous said...

Outside of flying in Alaska, medivac helicopters have about the highest accident rate in aviation. More so at night and in IMC or marginal VMC. The real insult to injury is that someone else will decide you need this 'service' ... Even if it really isn't necessary.

There need to be restrictions on when the service will be used and how much they charge.

Anonymous said...

Furthermore, these operators are going to shoot themselves in the foot. The rampant greed and exorbitant charges will result in legislation and government regulation.