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Insurance Consumer Advocate

Sha'Ron James

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Mailing: 200 East Gaines St.
Tallahassee, FL 32399-0308

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Air ambulance prices double, GAO says. Should Florida do anything?


Date: August 07, 2017
Source: Palm Beach Post
Author:  Charles Elmore


Helicopter air ambulance pricesapproximately doubled in four years, a new government report finds as Florida officials consider possible legislation by next spring to limit what consumers pay for emergency transportation.

The median price rose from around $15,000 to about $30,000 per air trip between 2010 and 2014, according to Medicare data from the Centers for Medicare & Medicaid Services and private health insurance data, a U.S. Government Accountability Office report found.

Paul Webster, vice president of air ambulance provider Air Methods Corp., talks to a state panel in June.

“Air ambulance providers might bill a privately-insured patient for the difference between the price charged and the insurance payment— a practice called balance billing— when the provider lacks an in-network contract with the insurer,” the GAO report said.

Balance billing is the amount consumers can be charged, sometimes to their shock, after insurers or agencies have paid what they see as appropriate. It’s a key issue for a state working group led by Florida Insurance Consumer Advocate Sha’Ron James. State officials have heard examples of consumers charged up to $1,000 or more for ground ambulances, and up to $42,000 for air transport.

While grateful for life-saving services, many consumers question why they should be billed an open-ended amount for an ambulance ride that could strain family budgets or push some toward bankruptcy. Many already paytaxes for municipal services in addition to insurance premiums. They don’t realize most ambulance services, private or public, decline to join insurer networks.

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

For their part, air ambulance providers have questioned whether federal law lets states regulate prices for air travel, plus they say insurers often want to pay too little to keep them in the air.

“We would love to go in network” with insurers, said Paul Webster, vice president ofColorado-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.”