Montana Lawmakers Seek Support for 2 Air Ambulance Regulation Bills

Montana lawmakers on Thursday moved forward with two measures that seek to prevent patients from receiving huge bills from air ambulance providers that are not in network with their insurance plans.

The Senate endorsed a bill on second reading that would hold patients responsible only for the co-payments and deductibles required under their insurance plans and the insurance company and out-of-network air ambulance providers would have to negotiate over the rest of the bill.

The bill was the product of a working group that heard from patients who had received financially crippling bills for tens of thousands of dollars. Private air ambulance companies said insurance companies weren’t offering enough compensation while insurers argued non-hospital based air ambulance companies wouldn’t disclose their actual costs to help determine a fair price.

Senate Bill 44 outlines a process to determine the fair market value of air ambulance services if they cannot reach an agreement. An independent reviewer would take into account the training and composition of the air ambulance crew, the amounts usually charged and accepted for payment for such services in Montana and the Medicare payment rate.

Democratic Sen. Tom Facey, of Missoula, said the working group tried to find a solution that could not be overturned under the federal Airline Deregulation Act, which does not allow states to regulate the fares or routes of airlines. Courts have determined that the act applies to air ambulance companies.

Republican Sen. Ed Buttrey, of Great Falls, said discussion of the issue has led to some changes, including some hospitals eliminating first-call agreements they had with private air ambulance companies. He said hospitals also are taking patients’ insurance coverage into account when transports are able to be scheduled ahead of time.

Bill sponsor Republican Sen. Gordon Vance, of Belgrade, urged the Senate to show Montanans that “both sides of the aisle can work together and work toward a solution that would be best for everybody.”

Lawmakers endorsed it with a 48-0 vote. The bill must be reviewed by the Senate Finance and Claims committee before it will face a third and final vote in the Senate.

Also Thursday, the House passed a bill on third reading that would allow the state to regulate air ambulance memberships like insurance products.

Air ambulance companies sell annual memberships that cover out-of-pocket expenses for a medically-necessary air ambulance flights, meaning the company will accept the patient’s insurance reimbursement as payment in full.

The bill that passed on a 98-0 vote requires air ambulance companies with membership programs to have a certificate of authority to operate and not advertise their plans in areas where they do not regularly provide service. House Bill 73 now moves to the Senate.