(Jefferson City, MO – Insurance News 360) – Missouri residents are affected by large bills and aggressive collection tactics after using air ambulance providers, according to a report released on Jan. 8, 2019, by the Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP).
The DIFP initiated a data call for insurers in the state and analyzed fully-insured health coverage under the department’s regulatory purview. The result is that they uncovered an estimated $25.7 million billed for air ambulance services in 2017, a potential for a maximum of $12.4 million in balance-billing for Missouri residents. The report revealed that residents with private insurance have been balanced billed for more than $100,000; and that many air ambulance providers do not participate in many health insurance provider networks.
Some air ambulance providers engage in aggressive collection efforts to collect amounts not paid by private health insurers, including filing lawsuits and placing liens on homes. A quick search of Missouri’s court records returned over 184 records since 2012 for one of Missouri’s largest air ambulance providers. The four most legally active providers together had 427 actions over the same time period, with recoveries commonly in the tens of thousands of dollars.
“With air ambulance bills, Missourians are subjected to extremely aggressive collection efforts, at a time when they are quite vulnerable as they are already recovering from a medical emergency”, said Director Chlora Lindley-Myers. “We hope this report illustrates to state and federal policymakers the scope and seriousness of this problem and the need for urgent action.”
In investigating complaints regarding air ambulances, the Department’s jurisdiction is limited to fully insured health plans, covering approximately 1.2 million Missourians in 2017. The Department has no authority to assist consumers who are covered under self-funded group health plans, which cover approximately 1.9 million Missourians.
The investigations ensure that the insurer is in compliance with relevant state insurance laws as well as their own contractual language. The Department also is, in many instances, unable to assist consumers who have been saddled with unpaid air ambulance bills when the insurers’ actions do not clearly run afoul of insurance regulatory standards. States generally have very limited regulatory authority over air ambulances in general.
Air ambulance services are governed by the federal Aviation Deregulation Act (ADA) of 1978, which carved out broad federal preemptions to state regulation of aviation. The act specifies that states may not regulate in any way the “price, route or service of an air carrier.” The National Association of Insurance Commissioners has been engaged on this issue and in working with members of Congress to find ways to protect consumers from the financial devastation of air ambulance balance bills.
Source: Missouri Department of Insurance.