The National Advertising Division (NAD) of BBB National Programs determined that Global Medical Response, Inc. (GMR) provided a reasonable basis for certain advertising claims for its Air Ambulance Transport. However, NAD recommended that the advertiser clearly disclose qualifying information related to its AirMedCare Network (AMCN) subscription membership program. The claims at issue were challenged by Air Methods Corporation, a competitor in the emergency air medical transport services industry.

The emergency air medical transport services industry operates primarily in rural zip codes across the nation where there is little to no access to high-level emergency care. The challenger and advertiser offer air medical transport services via helicopter with trained medical professionals to hospitals, trauma centers, and other such high-level care. The helicopters are dispatched at the request of first responders, hospitals, or physicians. Typically, the closest air ambulance, regardless of the company, is dispatched. A patient cannot directly dispatch a helicopter on their own and the parties cannot self-dispatch.

After the transport, patients are charged a fee by the air ambulance company. If the patient has insurance, the patient may be responsible for a portion of the fee, such as the co-pay and/or deductible. Any amount not covered by insurance is called the balance bill.

The challenged advertising claims relate to the advertiser’s AMCN subscription membership program. Under this program members pay an annual fee and if the member is flown by an AMCN air ambulance, GMR considers any charges for the emergency transport, beyond the amount paid by the member’s insurance or any other responsible third party, to be paid in full.

“No Out-Of-Pocket Expenses” Claims

NAD considered the meaning of the terms “no out-of-pocket expenses” and “never pay a dime” and determined that such claims refer to the amount ultimately paid by the member (after receiving payment from insurance or other responsible entities). NAD found that GMR supported such claims because a member pays no type of balance bill whether insured or uninsured.

However, NAD determined that GMR’s “How it Works” webpage fails to clearly disclose that the “no out-of-pocket expenses” promise only applies if the member is transported by an AMCN provider. Therefore, NAD recommended that the advertiser modify any “no out-of-pocket expenses” and “never pay a dime” claims to clearly and conspicuously disclose that the membership benefit applies only if flown by an AMCN provider.

Further, NAD determined that GMR’s “How it Works” webpage, a one-page AMCN mailer, and a podcast advertisement can reasonably be interpreted to convey the unsupported message that members can choose to be flown by an AMCN provider and as a result will not be responsible for out-of-pocket expenses. NAD found that a key term of AMCN’s membership program is that members have no control over which ambulance transports them in a medical emergency. Accordingly, NAD recommended that GMR modify all advertising for its membership program to clearly and conspicuously disclose the fact that the dispatch of an air ambulance is in the control of the first responder and not the member.

Peace of Mind Claims

NAD determined that in each of three challenged advertisements, GMR’s claim “financial peace of mind,” as modified, refers to a specific measurable financial benefit provided by GMR. NAD found that forgiving a member’s co-pay or final balance bill is a financial benefit, therefore the claim “financial peace of mind” is supported.

Provider Coverage Map

NAD determined that one reasonable message conveyed by the advertiser’s AMCN provider coverage map, along with the language “as a member of the country’s largest air medical flight membership network you are covered at home and by more than 320 locations across 38 states,” is that membership guarantees transport by an AMCN provider, a message not supported by the record. Therefore, NAD recommended that the coverage map be modified to clearly and conspicuously disclose that membership does not guarantee transport by an AMCN provider, and that dispatch of an air ambulance is in control of the first responder and not the member.

No Surprises Act Claim

The No Surprises Act, passed by Congress in December 2020, prohibits balance billing for patients with private commercial insurance or ERISA plans.

Air Methods took issue with the claim “Some AMCN competitors, including Air Methods, have made the claim that there is no need for membership as a result of HR133. This is categorically false and an outright lie” that appears in a document called “Membership Matters Talking Points” on GMR’s website. NAD found that a reasonable consumer could take away the message that Air Methods has been deceiving consumers by lying to them about the No Surprises Act and the need for memberships. While the parties disagreed about how the No Surprises Act affected memberships programs in the previous NAD challenge; there is no evidence in the record of Air Methods deceiving or lying to consumers in the current challenge.

NAD recommended that GMR modify its advertising to avoid conveying the message that Air Methods or any other competitors lied to or deceived consumers regarding the No Surprises Act and the usefulness of memberships.

In its advertiser statement, GMR stated that while it “believes that it has clearly and conspicuously disclosed that an AMCN membership only applies to transports by AMCN providers, and that first responders and emergency dispatchers determine which provider is called, it will take steps to comply with NAD’s recommendation that clarify these disclosures.”