New Bill Calls for Consistency in Billing Costs for Air Ambulances

Liz Carey

Atlanta, GA ( – A 1980s law that deregulated airline traffic shouldn’t be used to allow air ambulance services to avoid price limits for workers’ compensation issues, advocates for a new federal law say.

Frank McKay, chairman and chief appellate court judge with the Georgia State Board of Workers’ Compensation, wants Congress to pass a law that would allow states to set limits on air ambulance rates.

The Isla Rose Life Flight Act, SB 471 would allow states to regulate air ambulance rates. McKay is urging workers’ compensation professionals to call or write their Congressmen to urge them to consider legislation that would support legislation enabling states to set fee schedule guidelines for air ambulance services.

As it is, he said, laws passed in the 80s are being interpreted as to give air ambulances carte blanche on setting their own rates.

“In 1987, the Airline Deregulation Act was passed by Congress to deregulate the commercial airlines,” McKay said. “What air ambulance companies are saying is that the Airline Deregulation Act pre-empts state’s rights over fee controls of air ambulances. We don’t believe that it is as board as to include state medical fee schedules for workers’ compensation.”

While states have been able to establish fee schedules for ground ambulances, he said, some states, after trying to do the same with air ambulance fees, have had those fee schedules challenged in court — most notably in Georgia, Montana and Texas, he said.

“It’s a huge position taken by air ambulances that there is no regulation what so ever on their fees,” he said. “Some states have seen exorbitant fees charged (in workers’ compensation cases) because there are no fee guidelines at all.”

Trips in air ambulances have ranged between $40,000 and $80,000 in some states, he said.

AirMed Care, an air ambulance network in Dallas/Ft. Worth, did not return calls for comment by press time. According to its website, an average air ambulance flight costs $18,000.

Per Consumer Reports, patients transported to hospitals by air could many times have been safely transported by ground ambulance. But when the patients are taken by air ambulance, insurance companies will only pay a fraction of the average $30,000 per flight. The magazine said it found a spike in complaints about air ambulances in the months preceding the report.

Transportation by air ambulance may increase the risk to patients. Ambulances crash more often than other air taxis, the report found.

And the number of air ambulances has doubled since 2000, many now operating as for-profit entities, the report said. Four major companies account for about half of all the industry’s revenue. Additionally, fees for the services are going up. Air Methods, one of the largest for profit air ambulance services, increased its fees from $13,000 in 2007, to $50,200 in 2016, according to Research 360, an independent research firm. The average bill industry-wide in 2014 was $32,895.

Rich Sherlock, president and CEO of the Association of Air Medical Services, told Consumer Reports that many air ambulance patients are on Medicare or Medicaid, and that those programs pay $200 to $6,000 per transport. Because of that low payment, he said, air ambulance providers must charge more to people with private insurance to make up the difference.

McKay said the legislation should reach Congress soon. A federal aviation bill is pending before Congress currently, but that legislation does not include a carve out for workers’ compensation, he said.

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