Policy viewpoint: End outrageous air ambulance bills

Air ambulance companies that don't disclose prices before providing services and obtain patient permission should only be allowed to collect average market prices at most, three authors, including two physicians, wrote in an opinion piece published by STAT.

The opinion piece — by Kevin Schulman, MD, a professor of medicine at Stanford University; Barak Richman, professor of law and business administration at Duke University; and Arnold Milstein, MD, professor of medicine and director of Stanford University's clinical excellence research center — addresses how to stop patients from receiving high unexpected medical bills after air ambulance rides.

These surprise bills occur when a provider charges from its chargemaster, an overall pricing list for hospitals' services and products, which does not reflect negotiations with insurance companies. Surprise bills often happen when the patient is uninsured, or when the provider is not part of the patient's insurance network.

The authors partially attribute the problem to recent interpretations of the Airline Deregulation Act, which deregulated air ambulance companies, allowing them to avoid most state price regulation. As a result, air ambulances may charge chargemaster prices.

But authors said if companies can only collect prices they have adequately disclosed — per rudimentary contract law that applies to other industries — "then normal market mechanisms can create market prices, reward managers for investment decisions that create real value, and protect consumers against naked abuses."

Read the entire opinion piece here.


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