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Proposed federal law takes aim at 'surprise billing' from air ambulances

Posted at 10:13 AM, Oct 25, 2019

SOPERTON, Ga. -- For Teresa Cammack, gardening is a life-long passion.

“Even pulling weeds,” she said. “You know, never thought it would just be so incredible to do that.”

It's incredible to her because, just one year ago, Cammack had a massive stroke.

“It was absolutely terrifying,” she said. “I could feel the weakness. Honestly, I could just feel the life just kind of leaving my body.”

Her sister found her lying on the bathroom floor in her home in Soperton, Georgia: population about 2,900. The closest major hospital there is about an hour and half away. With time critical to Cammack’s survival, local paramedics called for an air ambulance.

“It’s all a matter of saving time,” said Rafe Waters, program director for the Air Evac Life Team based in Vidalia, Georgia.

In these cases, time can be the difference between life and death for accident victims, and heart attack and stroke patients.

“Time is muscle, time is brain cells and that’s the biggest advantage to this,” said flight paramedic Marshall Worth.

However, a proposed bill now in the U.S. Senate – S. 1895 – could place restrictions on how much air ambulance companies can charge. The “Lower Health Care Costs Act” calls for “ending surprise ambulance bills,” whose costs can range anywhere from $10,000 to $40,000 and are not usually fully covered by insurance.

Lower bills might sound great, but air ambulance companies said the bill would force them to charge only a median rate, which they argue is too low and would put them out of business.

“The current Senate health language would cause a number of air medical bases to close and people who live in those rural areas of the United States would lose access to health care,” said Richard Sherlock, president of The Association of Air Medical Services.

Already this year, 38 air medical bases have closed because of too few patients and high operating costs. They are not the only ones under financial pressure – so are rural hospitals.

In Soperton, there used to be a hospital – Cammack was born in it – but it closed years ago. Hospital closures are increasingly becoming a problem for rural communities across the country.

“So many people, especially in bigger cities, take for granted ‘hey, there’s a hospital that can treat me, five minutes from where this wreck was at,’ and that’s what this is for these areas,” said flight paramedic Worth. “It’s invaluable.”

Johns Hopkins Carey Business School professor Ge Bai is a health policy expert and helped write the proposed Senate bill.

“Good luck – you’re likely to pay a very high price for this trip,” Bai said, adding, “I think this air ambulance issue is the poster child of surprise medical billing.”

Bai said patients often have no choice when it comes to using an air ambulance – and since many insurance companies don’t pay – patients can get stuck with huge bills.

“These are perfect ingredients to make the patients the most delicious prey,” she said.

However, air medical services believe the better solution would be to have them deal with insurance companies directly and take patients out of the middle.

“We think those discussions should take place directly between the providers and insurers,” Sherlock said.

Back in Georgia, Cammack said she’s just grateful she got help for her stroke in time and said everyone should hope to be as lucky.

“You just don’t ever think it could happen to you,” she said, “but it can.”

If you ever do end up needing an air ambulance, Bai said you should try to negotiate with the company, to see if you can get a discount on the bill.