Ban on air ambulance balance billing sought in Florida

Sha`Ron James, Florida's insurance consumer advocate, is calling for consumer balance billing protections for emergency medical transportation services such as ground and air ambulances.

Balance billing occurs when a medical provider charges an amount for their services, and the patient is responsible for costs not covered by insurance. It often happens in emergency situations when the provider is not part of the patient's insurance network, and leaves consumers with unexpected charges.

Florida is among the states where balance billing is prohibited. However, the ban does not cover EMT services, according to Ms. James.

"By paying their premiums and deductibles, private insurance consumers have the reasonable expectation that they and their families will be covered if they need emergency medical transportation," she wrote in a recent report issued by the ICA. "Many Florida consumers are shocked to learn that air and ground EMT services are often considered out of network by their healthcare plans, and that they owe several hundred, or in some cases thousands of dollars, for the use of these services."

While states such as Florida have made efforts to protect consumers from balance billing, their laws do little to lower air ambulance costs. This is because under federal law, air ambulances have few restrictions on the amount they can charge for rides, reports Bloomberg.

Ms. James recommended efforts be taken "to deregulate the aeromedical industry from federal regulation, so that states may more appropriately regulate the market to address consumer needs."

Multiple groups responded to the report.

The Florida Ambulance Association, which primarily includes ground ambulance members, recommended the continuance of  balance billing for ambulance services.

"Because reimbursement is below cost, we do not recommend that ambulance services be excluded from balance billing at this time," the association told The Palm Beach Post. "However, we continue to whole-heartedly support efforts to fill this critical void."

The Save Our Air Medical Resources, a national campaign focused on access to air ambulance services, called the report "flawed" in a statement to Becker's Hospital Review
SOAR spokesperson Carter Johnson said: "Although the agency solicited input from air medical providers and other EMS providers, its report failed to acknowledge critical information about air ambulance operations and billing, and the growing trends in insurance practices of coverage denials and under-reimbursement, all which were shared during open hearings. As a result, participants in the ICA's working group dispute the recommendations and caution policy makers to disregard the report's flawed recommendations."

Read the full ICA report here.


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