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Air ambulances: The pain of the accident, the suffering of the bill


Date: September 21, 2017
Source: ABC 27
Author:  Dennis Owens


HARRISBURG, Pa. (WHTM) – In the worst of times, air ambulances are often the best option.

“A heart attack, a pulmonary embolism, a severe head injury, these are circumstances where you need care. You need it fast and it’s probably going to save your life,” Acting Insurance Commissioner Jessica Altman said.

“I was in an accident Easter Sunday,” recalled Chambersburg’s Justin Poe, who experienced the accident’s pain andthen the suffering of the bill.

“I was shocked to find out it was $41,000,” saidPoe.

Gary Karwaski of northeastern Pennsylvania was flown to a Scranton hospital after a fall from the roof of his remote cabin. He hurt his back but says the bill broke his bank. Gary was charged more than $42,000 for the flight.

“While I greatly appreciate the service that was provided, the whole affair has caused me more mental anguish than the actual injury that I suffered in the fall,” he said.

They are not unusual cases.

“I’ve had people in my office with these bills saying, ‘what am I going to do?'” state Rep. Tina Pickett (R-Bradford/Sullivan/Susquehanna) said.

Pickett chairs the House Insurance Committee but is helpless to fix the problem. Congress’s airline deregulation of the late 1970’s bars states from regulating air ambulances.Pickett says several of herconstituents have been traumatized.

“I have one gentleman who is definitely in bankruptcy over it,” she said. Pickett.

Altman says she’s seen bills as high as$50,000.

Is the patient on the hook for that? Do they have to pay?

“Yes,” Altman said, which is not a satisfying answer.

“I agree. That’s why we’re here right. That is the problem.”

A problem with many causes.

“It costs money to have helicopters on standby 24-7, 365 days, placed strategically throughout the state,” said Andrew Wigglesworth, a spokesman for the state’s Air Medevac Coalition.

Wigglesworth says that onaverage, an air ambulance flight costs $11,000, but the helicopter companies rarely collect that much.

He says two-thirds of the patients are on Medicare, a federal program, or Medicaid, a state program.

Medicare reimburses air ambulance companies just over $5,000. Medicaid pays $200 bucks plus $2 per mile after the first 20 miles.

“Basically, that mileage charge is less than a taxicab ride in the city of Philadelphia,” Wigglesworth said.

It’s also less than the cost of fueling the helicopter, not to mention the trained staff and equipment necessary to save lives.

Eleven Medevac Coalition CEOs – including Hershey’s Life Lion and Geisinger’s Life Flight – wrote to state lawmakers asking for higher Medicaid reimbursements. They insist it’s crucial for the health of the system and the safety of all Pennsylvanians.

“If the service on average costs $11,000 and two-thirds of the people are paying less than 50 percent of that average cost, then the cost is going to increase for others,” Wigglesworth said.

Others like Justin and Gary aren’t Medicaid or Medicare patients. They are privately insured. Private insurance companies may or may not pick up the whole tab for the air ambulance. If they don’t, patients are responsible for the balance. It’s called balance billing. The concept of making a relative few pay more for a service tocover for the majority who aren’t paying enough is called cost shifting and Altman hates it.

“It’s unfair to the consumer to have to pay that burden when they can’t afford to pay it,” Altman said. “You shouldn’t have to choose between your life from a literal perspective and your life from a financial well-being perspective.”

Karwaski hired a lawyer and fought his bill and was successful. He ultimately settled that $42,000 bill for $7,500. But he calls the entire experience painful.

“When my wife and I are now driving somewhere in a car and we see an air ambulance in the sky, we look at each other as if to say, ‘I wonder if those poor people have any idea what awaits them.'”

Both the insurance commissioner and industry representatives recommend that patients try to negotiate a resolution if they’re hit with an exorbitant bill. That does work. But if not, Altman says to call her office.