The United States Congress is considering H.R. 3378/S. 2121, the Ensuring Access to Air Ambulance Services Act, an important piece of legislation that would protect access to air medical services by modernizing the Medicare Air Ambulance Fee Schedule. The legislation is sponsored by Reps. Jackie Walorski (R, IN-02), Suzan DelBene (D, WA-01), Bill Johnson (R, OH-06), Raul Ruiz (D, CA-36), and Pete Sessions (R, TX-32) and Sens. Dean Heller (R-NV), Michael Bennet (D-CO) and Cory Gardner (R-CO). Key elements of the legislation include:
- Requiring air medical operators to collect and submit cost data to HHS so that it can develop an accurate payment system based on actual costs of providing care;
- Establishing a mandatory air medical quality reporting program;
- Implementing a value-based purchasing program to promote high-quality air medical services;
- Providing reasonable immediate, but temporary, relief to providers while the data collection and analysis is occurring; and
- Remaining budget neutral.
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.