- Info from USA Today

Consumers nationwide have been shocked with sky-high medical flight bills that insurers won’t fully cover. And unlike other health care costs, federal law prohibits states from regulating medical-flight fees.

Air ambulance companies have come under increasing scrutiny as their billing costs—and profits—have soared.

One reason charges may have increased: The air-ambulance industry has expanded quickly, adding helicopters faster than patient demand has grown, data compiled by Dr. Ira Blumen, medical director of the University of Chicago’s Aeromedical Network show.

Insurers argue that medical flight businesses use patients as pawns to recoup money from inflated bills. Media investigations have shown some companies have used hardball tactics to get patients to pay, including harassing phone calls, hiring debt collectors and placing liens on business.

Air ambulance advocates say flying intensive care units 24 hours a day is expensive, and few flights are fully reimbursed. Being ready to deploy advanced fleets and highly trained clinicians and pilots at a moment’s notice requires substantial investment and high fixed costs.

As many as 7 of 10 flights are underpaid because Medicare and Medicaid haven’t updated their rates in years and private insurers often refuse to pay full freight. Even with in-network agreements, the blame game goes both ways with insurers and air ambulance companies arguing the other won’t accept reasonable fees for service.

Each side contends that competing bills in Congress could solve some of the problem.

Medical flight operators support legislation that would increase Medicare payments and require transparency around flight costs. Insurers back bills that would give states power to regulate air ambulance fees and clearly separate the medical costs from the transportation costs on a patient’s bill.

Both insurers and air ambulance operators generally employ patient advocates to help people navigate the billing process to reduce charges to patients. ◙