Air ambulance service predicts base closures if medical transparency bill becomes law

BOWLING GREEN, Ky. – Senate Bill 1531, also known as Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019, is under review by the United States Senate.

The bill is meant to stop surprise billing from out of network medical practices.

“If you’re like me and you had a child go to the hospital recently and you are continuing to get bills and you don’t know what they are for or how to read them, we are going to try to get some transparency in that,” said Republican Congressman James Comer.

While the bill is well supported by both parties, Air Evac Lifeteam, an air ambulance service with a base in Bowling Green, is worried about how the wording of the bill could affect business.

“There are a lot of health insurance companies that are fighting that, medical professionals that are fighting that, but it’s something that the people want and deserve. I think if you go to a medical professional, you should know how much the procedure you are going to get is going to cost,” said Comer.

“Your insurance company has negotiated a rate, then you just have a copay and deductible if you’re in network. That was dealing with physicians so that if you go to the hospital and some of the people in that hospital are not part of the hospital, then you get what you call a surprise bill after the fact,” said Seth Myers, president of Air Evac Lifeteam.

According to data reviewed by the U.S. Government Accountability Office in 2017, about two-thirds of air ambulance transports for patients with private insurance were out-of-network.

“What the Senate bill does is, essentially, it puts air ambulances in network, whether they are in network or not, and comes up with a set price for air ambulances. What I have supported in the House is for us to really find out what the costs are,” said Republican Congressman Brett Guthrie.

Generally insurance only pays for a portion of an out-of-network service, according to the GAO.

In that case, a patient could be billed for the difference between what the air ambulance provider charges and what patient’s insurance paid—which is known as balance billing, also called surprise medical billing.

 “So, the question we have to ask, and we don’t know the answer to is, if we lower the amount air ambulances can receive, does that shrink the number of air ambulances. We don’t know the answer to that and that’s why I want to get to the bottom of it,” said Guthrie.

“If Senator Alexander’s Bill would go through as written, you would see more air ambulance bases closed. We’ve seen over 35 air ambulance bases close just since the beginning of this year because they are financially strained already and this would only worsen that problem,” said Myers.

Lower payments from government-funded health care are cause for concern for air ambulance providers.

 “Medicare is woefully under-reimbursing air ambulance and has been ever since we set the fee schedule done with 1998 dollars in mind when we did it back in the year 2000 and we have seen less than 2 percent increases since it was implemented in 2002,” said Myers.

“The other argument is, because Medicare and Medicaid paid so little, the private sector has to pay more. We see that in a lot of health care. So, my position is, let’s get to the bottom of it,” said Guthrie.