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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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Surprise bills: Ambulances out of health networks draw panel's scrutiny

 

Date: October 12, 2016
Source: Palm Beach Post
Author:  Charles Elmore

 

A state working group that meets next week will examine a piece of the puzzle left out of last spring’s legislation designed to fight surprise medical bills for consumers: Ambulances.

Consumers like Penny Farrow of Boynton Beach have found it “outrageous” people have to pay hundreds or sometimes thousands of dollars because ambulance services typically refuse to join insurance networks, as The Palm Beach Post has reported.

Consumers often pay local taxes for ambulances and premiums for insurance only to get whacked in the wallet again when they call 911. Many people say they find this frustrating and unfair, because it’s not like they can shop around for an in-network ambulance service in an emergency. They generally have no choice.

“I am pleased to announce the formation of the Office of the Insurance Consumer Advocate’s Emergency Medical Transportation Working Group,” Sha’Ron James, the state’s insurance consumer advocate, said this week. “Florida consumers may be shocked to learn that many air and ground emergency medical transportation services are often considered out-of-network by their healthcare plans, and that they owe several hundred or, in some cases, thousands of dollars for the use of the service.”

The group’s focus will be “addressing the needs of Florida’s insurance consumers by identifying solutions that may address issues and concerns faced by the ambulance service, insurance industry, and ultimately the insurance buying public,” she said.

A Palm Beach County Fire Rescue spokesman did not immediately respond to a request for comment, but a member of the working group representing the Florida Ambulance Association said being forced to join insurer networks, for example, could have a “substantial impact.”

It likely means higher local taxes — or new taxes in some counties where ambulances are not already subsidized — or “we’d have to cut services,” Joe Scialdone, EMS billing manager in Escambia County.

A similar argument was successful in getting ambulances removed from the bill that passed last session. The bill signed by Gov. Rick Scott limited what medical providers such as radiologists and anesthesiologists can charge consumers in situations where patients have no meaningful choice of providers.

The national advocacy group Consumers Union said the legislation put Florida at the forefront of efforts to fight surprise medical bills.

“The involvement and feedback from folks in Palm Beach County was crucial in highlighting the face of the issue,” James said at the time. “As a result of the Post’s interest in the issue, we received many phones calls and messages from consumers who had experienced surprise medical bills.”

The first meeting of the working group is set for Monday at 9 a.m. in Tallahassee.