Nearly 70% of air ambulance transports in 2017 put patients at risk of balance bills, GAO says
- About 69% of air ambulance transports were out-of-network in 2017, putting patients at financial risk, a government report analyzing private insurance data found.
- However, it's unclear how many patients received balance bills stemming from out-of-network issues, the Government Accountability Office said. "There is a lack of national data on balance billing," the report noted, though some states have attempted to keep tabs on its frequency.
- Air ambulance providers and insurers admit the share of out-of-network transports were high, but said they recently had entered into more in-network deals, potentially alleviating a portion of out-of-network rides.
Despite having insurance coverage, some patients are left with sky-high bills after being transported by an out-of-network air ambulance. Typically, insurers only pay a fraction of the out-of-network bill, leaving a "balance" the air ambulance company then sends to the patient.
The problem stems from insurance carriers and air ambulance providers failing to come to terms on in-network contracts, leaving patients on the hook for major bills. The median price charged by providers for a helicopter transport was $36,400, according to GAO's analysis.
After widespread reporting on patients stuck in the middle between air ambulance carriers and insurers, some states tried to protect patients from balance bills. But many states found certain federal laws preempt many of their efforts. Air ambulances are regulated just like air carriers under the eyes of the federal government and states cannot regulate prices or routes of air carriers. Also hampering states abilities to rein in balance bills are self-insured plans that are regulated by federal ERISA laws. Though some have proposed workarounds for states such as regulating billing and contracting.
The report comes after Congress inched closer to consumer protections in this arena. Last year, lawmakers passed a bill to reauthorize the Federal Aviation Administration, and tucked inside were provisions to establish a federal advisory committee tasked with reviewing and making recommendations regarding air ambulance issues. The bill also required air ambulance providers to include the Department of Transportation complaint hotline on all bills sent to patients.
The latest GAO report also builds upon its 2017 report on rising prices in the industry, which recommended greater transparency and streamlining consumer complaints about air ambulance issues and making them readily available to the public.