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Insurance Commissioner Supports Congressional Passage of FAA Re-Authorization Bill with Pro-Consumer Air Ambulance Amendment

Harrisburg, PA - Insurance Commissioner Jessica Altman today commended Congress for passing a pro-consumer amendment concerning air ambulance services, as part of the Federal Aviation Administration (FAA) re-authorization bill. 

“This bill includes language establishing an advisory committee to make recommendations for a rulemaking at the federal level that would provide more consumer protection for people who use air ambulance services,” Altman said. “This proposal would bring greater transparency to the air ambulance services invoices, which I believe is a good first step in helping protect consumers from sometimes huge balance bills they receive when they use air ambulance services.”

The advisory committee is to make recommendations for a rulemaking to require air ambulance operators to clearly disclose charges for air transportation services separately from charges for non-air transportation medical services provided while onboard an aircraft, and to provide other consumer protections for customers of air ambulance operators. The committee will include the federal Secretary of Transportation as well as representatives of other relevant federal agencies, and representatives of the air ambulance industry.

“Significantly, this committee will also include a state insurance regulator, a representative of a health insurer, and a representative of a consumer group, making certain the voices of consumers and insurers who pay these bills, and state regulators who deal with health insurance billing issues daily, are heard when any federal rulemaking on protecting consumers is written,” Altman said.

Altman said the bill does not specify what consumer protections should be in the federal rule, but includes specific references to allowing states to refer allegations of unfair or deceptive practices or unfair methods of competition by air ambulance operators to the federal Secretary of Transportation.  Altman noted she has heard from consumers and state legislators about the problem of air ambulances not affiliated with a hospital and not in an insurer’s network. 

“Air ambulances, by their very nature, are transporting a patient in an emergency situation. The consumer often has no choice over whether they are transported by air ambulance, or what air ambulance service is used to get them or their loved one to a facility that can provide the care needed as quickly as possible. Consumers are often faced with a balance bill from the air ambulance service, with these bills typically running into the tens of thousands of dollars. These bills can be financially devastating for consumers and their families, who are often already dealing with catastrophic events and significant health care needs,” Altman said. 

Examples of huge balance bills consumers reported to the Insurance Department after using air ambulance services include a patient involved in a car crash that rendered this person unconscious. The individual, while unconscious, was flown by air ambulance to a trauma center. His insurer characterized the situation as “not life threatening,” and consequently the individual, who had no say in this transport, had a $40,000 bill. 

In another situation, parents reported that their son suddenly became ill, and was diagnosed with a large brain tumor. He was life-flighted to another hospital and underwent surgery. The parents were told had they arrived a few hours later their son would have died. The couple’s insurer paid $10,675 of a $47,759 bill because the air ambulance service was out-of-network, and the parents were left with a $37,083 balance bill. 

While she views the advisory committee language included in the FAA Re-authorization bill as a positive step, Altman urged Congress to permit states to regulate air ambulance services. This regulation is now pre-empted by the federal Airline Deregulation Act of 1978. The National Association of Insurance Commissioners supports giving states this authority.

“We must find a way to protect consumers from experiencing these crippling bills at such vulnerable times in their lives. And, as we work to contain the cost of health care, air ambulances must not be overlooked. These vital services save lives but must be affordable to the consumers who need them,” Altman said.

MEDIA CONTACT: Ron Ruman- 717-787-3289

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