Sept. 11—Sen. Roger Wicker has joined with Missouri's Sen. Claire McCaskill in a bipartisan request for answers about billing abuses and oversight of air ambulance services.
The two senators sent a letter Friday to Secretary of Transportation Elaine Chao outlining concerns over possible consumer abuses and urging effective oversight.
The letter cites a report from the Government Accountability Office that found the median price charged by air ambulance providers went from about $15,000 to $30,000 between 2010 and 2014.
"Anecdotally, it is clear that a greater share of this cost is being passed along directly to consumers through a practice known as balance billing, but GAO was unable to determine the prevalence of this practice because of a lack of data," the letter stated.
Balance billing is a practice where the patient is charged over and above what their health insurance deems reasonable and customary. The extra payments don't count toward out-of-pocket maximums.
The Jackson-based Mississippi Health Advocacy Program has received a number of complaints from consumers who were asked to pay tens of thousands of dollars for air ambulance service after their insurance carriers had made payments.
"This is a good, practical first step," said Roy Mitchell, Mississippi Health Advocacy Program executive director. "It's great that Sen. Wicker is being responsive."
Balance billing issues involving air ambulance services have been among the most troubling the health advocacy program sees, Mitchell said. Because they are called in life-threatening, emergency situations, customers have few options, if any.
In Mississippi, there is a law against balance billing on the books; however, air ambulances are not subject to the law.
"Many states have tried to address these costs and the practice of balance billing by treating the service like other health-care services," the letter states. "However, the courts have consistently struck down these state laws citing the Airline Deregulation Act."
The senators noted in the letter that the transportation department has begun collecting complaints about air ambulance services and making them public, a measure recommended by the GAO. Through July, there had been 16 complains logged for 2018. Mitchell said he believes the complaints in the federal database and those to his agency are the tip of the iceberg.
"The complaints don't accurately reflect the problem because people don't know where to turn," Mitchell said.
The letter from Wicker and McCaskill asks questions about the department's authority to investigate complaints and its ability to address the issue. The letter asks for responses by Sept. 28.
"This is an issue that not going to go away without some sort of consumer protection on a federal level," Mitchell said.
Air ambulance providers have pushed back against efforts to add consumer protections and regulations, citing insufficient reimbursement from Medicare, Medicaid and some private insurers.