Some Patients Have Received Bills Of As Much As $100,000

The Montana legislature's Economic Affairs committee is investigating reports of people receiving bills as high as $100,000 from emergency aircraft operators that are not affiliated with an insurance network.

In October of last year, Montana Commissioner of Securities and Insurance Monica Lindeen said in a news release that her office had received numerous complaints from Montanans who were transported by a private air ambulance service and were later billed many tens of thousands of dollars after their insurance company did not cover the cost of the ambulance ride.

Many Montana hospitals have their own air ambulance service. These services are in a health insurance company’s network and are covered by insurance. However, many stand-alone air ambulance services are not part of an insurance company network and those fees are not covered by insurance.  As a consequence, Montanans who are transported by private air ambulance services receive a “balance bill” for the amount insurance will not cover.

These bills have exceeded $55,000 and insurance is not contractually obligated to pay them.

Some private air ambulance carriers have begun marketing membership programs directly to Montanans. These “memberships” will cover the cost of the amount insurance will not pay.

Air ambulance provider billing practices, including membership programs, were even at that time under investigation by the Economic Affairs Interim Committee of the Montana Legislature.

The Great Falls Tribune reports that at a hearing last week, Bill Bryant of Sierra Health Group, speaking for a coalition of air ambulance services, said insurers need to change the way they bill. He said insurance companies want to make the same payment to everyone, and told the committee it should draft legislation to make insurance companies responsible for all costs less the deductible.

Don Wharton, speaking on behalf of REACHAir,a for-profit ambulance company, said Medicaid reimbursements were "woefully" below the actual cost of providing services. Meanwhile Pacificsource insurance spokesman Todd Lovshin said private air ambulance operators often do not return phone calls or emails to discuss rates. Others backed up that assertion that such companies were often unresponsive to inquiries about rates and billing.

The committee did not take any action at its meeting, but Jesse Laslovich, chief counsel for the state insurance commissioner’s office, said the legislature needs to be aggressive in looking for solutions to the problem. “We have to start narrowing our options and put solutions on the table,” he said. “This discussion has really exposed how broken the system is.”

(Image from file)

FMI: http://leg.mt.gov/css/default.asp