The Association of Air Medical Services (AAMS), a nonprofit trade association that represents over 90% of the air ambulance industry in the United States, released the following statement today on the new Surprise Medical Billing proposal, announced by Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-TN) and House Energy and Commerce Committee Chairman Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR):

“This proposal will allow insurance companies to continue to limit coverage of emergency air ambulance care, imperiling patient access to crucial, live-saving emergency care,” said Chris Eastlee, AAMS Vice President of Government Affairs. “We strongly believe that patients should not be in the middle of the balance bill disputes between insurance companies and emergency air ambulance providers, but this misguided approach will have catastrophic consequences for access to emergency air medical transport, especially in rural areas.”

The new proposal would:

• Limit out-of-network reimbursement to the median in-network rate; and
• Set a $25,000 threshold to access independent dispute resolution, which will often prohibit air ambulance companies from challenging bad-faith behavior by insurance companies.
• Does nothing to prevent insurers from denying claims and questioning the decisions of emergency physicians and first-responders acting on behalf of patients health.

Together, these two policies will allow insurance companies to systematically drive down reimbursement for emergency air ambulance services, and provides incentives for insurance companies to leave networks, discouraging in-network agreements.

This proposal will speed the closure of air ambulance bases across America.  In 2019 alone, more than 57 air ambulance bases—representing more than 5% of all air ambulance bases in the U.S.—have closed, all citing chronic government underpayment for patient care.

Instead, AAMS supports an alternative solution developed by Senate Commerce Committee Chairman Roger Wicker (R-MS) to protect patients from balance bills while ensuring continued access to emergency healthcare services in rural America.  Instead of setting an arbitrary benchmark rate, the proposal would take patients out of the middle by establishing an Independent Dispute Resolution process to adjudicate balance bill disputes between insurance companies and providers.  The proposal would also establish a data collection process to improve the transparency of pricing, patient billing and collections, and payment practices in the air ambulance industry.