Montana’s Air Ambulance Bill on Hold Pending Alternatives

A measure to prevent air ambulance patients from being hit with huge bills has been put on hold while governor’s officials and legislative leaders meet behind the scenes with groups to seek alternative solutions.

Gov. Steve Bullock’s budget director, two Republican senators and a Democratic representative met Wednesday with a lobbyist and a consultant representing a coalition of air ambulance companies. Separate meetings were previously held with insurance companies and hospital officials.

Neither the governor’s office nor the Legislature provided public notice of the meetings, but a reporter was permitted to attend Wednesday’s meeting in the governor’s Office of Budget and Program Planning’s conference room.

“What we’ve done at these meetings is give the three affected parties one last chance to sit down and work something out between them,” said bill sponsor Sen. Gordon Vance, R-Belgrade. “And if they don’t, I’m moving my bill.”

Lawmakers heard complaints earlier this month from people who used air ambulances to take them to hospitals in medical emergencies, only to receive bills for tens of thousands of dollars in out-of-network costs that weren’t covered by their insurance.

The air ambulance companies and the insurance companies blame each other for those huge bills, with the air ambulances saying insurers don’t pay enough to cover their costs and insurers saying the air ambulances won’t disclose those costs.

Other states that have tried to regulate air ambulances have been sued for allegedly violating a federal law that prevents states from interfering with fares and services.

Vance’s bill would require air ambulance providers and insurance companies to negotiate payments for services, even if the provider is out of the insurer’s network. Patients would be responsible only for co-payments, co-insurance and deductibles.

The bill received a lengthy public hearing on Jan. 10. Two of the state’s largest insurers opposed the measure, saying it would reward the air ambulance companies, force the insurers to raise their rates and not prevent air ambulances from price gouging.

No fewer than a dozen amendments were being drafted by various groups and lawmakers to change the bill, some of them “poison pills” designed to kill the measure, said Rep. Ryan Lynch, D-Butte.

That prompted the behind-the-scenes meetings between Vance; Lynch; Bullock budget director Dan Villa; Sen. Ed Buttrey, R-Great Falls; and the different groups. Villa set up the meetings, Vance said.

The aim, Villa said, was to get a clear understanding of what each group thought were the “joys and concerns” of the bill.

On Wednesday, they met with air ambulance lobbyist Scott Boulanger and consultant Bill Bryant, who spoke on the phone from Colorado.

Villa asked Bryant whether air ambulance companies would be willing to enter into voluntary contracts to limit their charges with insurers and the state, which self-insures government workers. Bryant responded that he believed they would, but the problem is that there have been no true negotiations between the groups.

“The insurance companies, in my opinion, have dug I their heels and said, ‘Nope, here’s what we’re going to pay, take it or leave it,” Bryant said. “And the air ambulance goes, `Well if we take it, we’d be out of business, so we’re not going to take it.”‘

Vance said afterward that the bill’s delay is only temporary and the measure will move out of committee “one way or another.”