In a life-threatening situation, being airlifted can be the best course for timely, critical care, but afterward, the patient is often met with an unexpectedly steep bill due to the current lack of pricing regulation.
CHEVY CHASE, Md. (PRWEB) August 21, 2018
As part of a coalition of 20-plus organizations seeking change in air ambulance regulation, the Society of Professional Benefit Administrators (SPBA) recently provided feedback to U.S. Senators who are currently working on the FAA reauthorization bill.
SPBA has actively shared its voice in the belief that reform is needed with regard to the rules and regulations that govern the air ambulance pricing structure. The association works directly with third party administrators (TPAs) throughout the country who are seeing their plans and patients face an increasing number of cases that result in exorbitant charges – up to tens of thousands of dollars – for air ambulance services.
In the letter provided to Senators John Thune (R-SD) and Bill Nelson (D-FL) by SPBA and a collaboration of health, transport and other industry organizations, several issues with air ambulances were addressed, including:
- The lack of state involvement in capping transport charges to a reasonable amount since air ambulances are regulated by the Airline Deregulation Act (ADA) of 1978, which is a federal law that continues to preempt any state involvement.
- Confusion with workers compensation claims, as it is often unclear which laws apply to air ambulance rates in these emergency care situations.
- The impact of soaring air ambulance costs on rural areas, as these locations are especially in need of services due to ground transport limitations when critical cases occur.
- Cost-shifting tactics that are used when Medicare and Medicaid don’t receive adequate reimbursement and add to the problems with rising air ambulance costs.
Anne Lennan, president of SPBA, explains, “In a life-threatening situation, being airlifted can be the best course for timely, critical care, but afterward, the patient is often met with an unexpectedly steep bill due to the current lack of pricing regulation.” She added, “What’s also discouraging is that so many patients are balance-billed even after air ambulance companies accept payment from health plans.”
The joint letter shared with Senators Thune and Nelson also mentions an amendment proposed to the FAA in 2016 that would have allowed states to have input on air ambulance regulation. It encourages the consideration of a similar proposal with current regulation while emphasizing the thought that must be given in cases that involve coordinating cross-border transportation.
“With both the utilization of and cost for these emergency air ambulance services going up, SPBA feels strongly that a better solution is needed for fair pricing now more than ever,” Lennan explained. “The patients who require this care deserve that.”
According to the Association of Air Medical Services (AAMS), there are an estimated 400,000 rotor wing transports in the U.S. each year and another 150,000 fixed wing transports.
SPBA is the national association of Third Party Administration (TPA) firms that manage client employee benefit plans. It is estimated that over 75% of U.S. workers and their dependents in non-federal health coverage are in plans administered by TPAs. The clients of TPA firms include every size and format of employment, including large and small employers, state/county/city plans, union, non-union, collectively bargained multiemployer plans, as well as most industries and professions.