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Sha'Ron James

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Air ambulances: Insurers call for end to balance billing to consumers


Date: June 13, 2017
Source: Palm Beach Post
Author:  Charles Elmore


Consumers should not receive devastating bills for tens of thousands of dollars for air ambulance transport when providers and insurers cannot agree on a reimbursement, a group representing Florida insurers told a state panel Tuesday.

That is often called “balance billing,” and participants cited cases of consumer charges ranging up to $42,000 or more.

“We believein a balance-billing prohibition,” said Wences Troncoso, vice president and general counsel of the Florida Association of Health Plans. He called for rules that would mean an air ambulance provider essentially has to work out payment with the insurer, not the consumer, he said.

But air ambulance providers questioned whether federal law covering air travel even allows states in effect to regulate prices and services, and they said in any case insurers often propose to pay far less than they need to stay in the air.

“We would love to go in network” with insurers, said Paul Webster, vice president of Colorado-based Air Methods Corp., a private operator of air ambulance services. “Unfortunately in many states we are met with rates we can’t live with and access would be limited.”

Florida Insurance Consumer Advocate Sha’Ron James, who hosted a working group meeting for the third time Tuesday, said bills often leave individual families “shocked.” At the same time, consumers are typically grateful for life-saving services and air transport remains a “distinct and complex” issue, she said.

The state’s emergency medical transportation working group is looking at possible solutions ahead of next year’s legislative session. An earlier session examined ground ambulances. After heavy debate, ambulances were left out of a law Florida passed last year that limited consumer charges from out-of-network medical providers in situations where the patient has no reasonable choice to shop around.