- Resolve the Medicare reimbursement shortfall by fixing the Medicare Air Ambulance Fee Schedule. When the fee schedule was set in 1998 it was not connected to actual cost data, and since its enactment, providers of air medical services have seen only limited inflationary updates averaging 2.2% a year. Over the same period, rapidly rising operational costs have outpaced air ambulance Medicare reimbursement, resulting in a cost shortfall of over 70% that will threaten access to air ambulance services, especially for rural communities.
- Study the matter in greater depth by developing a system to collect data regarding the operational costs of a typical air ambulance base and providing for a GAO and HHS study of the collected data, and by establishing ongoing reporting of industry-consensus clinical quality measures.
- Provide reasonable immediate, but temporary, relief to providers while data collection and analysis is occurring.
Work with states
Work with states to examine their current Medicaid reimbursement structure, and ensure that Medicaid rates reflect the true costs of service.
- While Medicaid reimbursement varies by state, in many states, Medicaid covers an even smaller portion of the cost for a transport than Medicare.
- Some states reimburse as low as 1/25 of Medicare. Pennsylvania and Utah reimburse only $200 per transport.
Encourage meaningful dialogue between air medical providers and insurance companies that is fair to all stakeholders, reflects true cost of service, and puts patients first.
For example, a recent study in Montana showed that for the minimal increase of only $1.70 per month in insurance premiums, air medical services can be reimbursed in full, meaning providers would not be forced to balance-bill, a problem the SOAR campaign has outlined how to address, and patients would see significant relief.
Preserve uniform carrier regulations in the Airline Deregulation Act (ADA) in order to ensure safe and effective delivery of air medical service. The ADA is a carefully crafted piece of legislation passed by Congress to ensure uniform federal authority over all laws and regulations “related to a price, route or service” of an air carrier. Air medical carriers are certified as Part 135 carriers regulated by the Federal Aviation Administration. Exempting air medical services from the ADA would allow states to regulate a wide range of issues in relationship to the aviation aspects of a licensed carrier—including where and when they are able to fly. This would effectively create borders in the sky, severely impact safety of aircraft, and create a patchwork of regulations and requirements on an industry that flies interstate on a daily basis.
Support increased transparency of emergency air medical transport costs through the U.S. Department of Transportation (DOT) and enforcement of any violations by the DOT’s Aviation Consumer Protection division.
Ensure safe and effective delivery of air medical service by preserving uniform carrier oversight, as written in federal law by the Airline Deregulation Act.