16-Mar-2022 Source: AAMS
Dear AAMS Members –
AAMS is working very hard to ensure every air medical program understands and supports our position regarding the AAMS lawsuit against the federal government’s rules implementing the No Surprises Act, a bill that AAMS largely supported and continues to support. We understand that questions still exist. As members of the AAMS Board, who voted on this position four times to ensure there was no ambiguity in our position, we feel it is our responsibility to further explain why this position is necessary and why every member and non-member benefits from this position.
AAMS’ position, in no way, harms hospital-based programs. This is false. The decision to put this argument before the court was made by an AAMS Board made up of mostly hospital-based programs. Nothing about our case is about “reimbursement”. Our case is about one thing only – a fair IDR process, where every member can make their case for fair payment from the insurer.
The AAMS case makes 4 arguments:
None of these positions should be considered stand-alone arguments. All the arguments serve one goal: to minimize the importance of the QPA in the IDR process. The QPA as a factor in the IDR process is the only provision of the No Surprises Act AAMS did not support. The legal strategy here must be viewed as a whole – to properly calculate the QPA to reflect actual network relationships between air ambulance providers and insurers, and to ensure that the QPA is just one factor in the larger IDR process.
AAMS firmly believes that every air ambulance provider benefits from these arguments. While it is extremely unlikely, let’s say for a moment the judge in the case decides in favor of only the separation of services argument, and there would be a separate QPA calculated by that insurer for that service in that region. In this case:
AAMS took this position for several reasons:
The recent decision in the Texas Medical Association case regarding the “weighting” of the QPA in the IDR process – the most important part of the AAMS case, which is now consolidated with and fully supported by the American Hospital Association, the American Medical Association, and a host of other hospital and healthcare associations – bodes very well for a decision in AAMS’ favor. HHS’ recent decision to revise their guidance on the IDR process is also good news, and we hope this indicates that the government accepts that their interpretation was not consistent with the law. But this is not over, and our case – now the AAMS, AHA, and AMA case – is still moving forward. A favorable decision in that case benefits every air ambulance program and all of healthcare.
Please do not be swayed by arguments to the contrary. These arguments are false. Accusations against the AAMS legal team misleading the Board are similarly false. We stand united, regardless of the ownership model of our program, in our support of this position. We stand ready to further explain this position and answer any questions from the membership at any time.
Sincerely,
The AAMS Board of Directors
René Borghese Administrative Director Duke Life Flight |
Kolby L. Kolbet Chief Clinical Officer LifeLink III |
James Houser CEO STAT MedEvac |
Deborah C. Boudreaux Assistant VP, Nursing Teddy Bear Transport Cook Children’s |
Ben Clayton Interim CEO and COO Life Flight Network |
Chris Hall Director, Government Affairs & Industry Relations PHI Health |
Rob Hamilton President: Alliances Global Medical Response |
Mike Perkins COO MedFlight of Ohio |
Stephanie Queen Chief Nursing Officer Air Methods Corporation |
Jeff Richey Executive Director Airlift Northwest |
Cindy Seidl Chief Clinical Officer STARS |