Health and Government officials ruled unfavorable for health insurers to cover medically necessary air ambulance transportation services.
Air ambulance transportation essentially allows aircraft including a helicopter to transport persons to a healthcare facility to receive health care services.
House Bill 1376 stated that any insurer or carrier who provided hospital, medical, or surgical benefits, would be covered for medical air ambulance transportation services. However, any carrier must insure that their provider includes a number of additional providers that support the use of air ambulance transport services.
Air ambulance companies are licensed to operate by the Maryland Institute for Emergency Medical Service Systems, allowing them to bill a patient or the patient’s insurance company provided that such patient received scene transportation. These licenses are valid for one year and can not seek reimbursement from the state.
HB 1376 was also effective for local governments that purchased fully insured health plans. This had an affect on small businesses because air transportation services were only eligible for insurance reimbursement under the bill.
In 2006, the Maryland Health Care Commission conducted an Air Ambulance study. This study examined the cost and reimbursement of services provided by air ambulance companies.
However, In 2015, Maryland Insurance Administration revisited this study and noted many complaints made about air transportation bills amounting to $20,000 plus, according to the First Reader background summary of HB 1376.
John Frederickson, Superintendent of Frederick County schools stated that one family received an air transportation bill of $43,806.
Although 2400 of his staff reporting to having health insurance of some kind, they still suffered from extremely high bills from air ambulance transportation when it was reporting not being an accident.
“We’re here to look at the legislation that might help us move forward for getting coverage for these families,” Frederickson stated.
Reports like these helped concluded that the state had limited answers regarding the significant balance that patients faced after they received emergency air transportation services.
Kimberly Robertson, spoke on behalf of the League of Life Insurers in Maryland. She stated that the number one challenge of air ambulance services is the cost and the impact on consumers.
She stated that Bill 1376 specifically causes trouble because the bill purports to mandate insurance companies who are unable to contract with air ambulance companies. Thus, they must pay the bill charge of that air ambulance company.
Robertson found that the federal law stands in the way of legislatures taking action. This results into pressuring insurers to pass those costs on through premium and ultimately finding that the cost of insurance is inaccessible for numbers of Marylander’s.
Furthermore, provisions with the medical plans does not allow persons to be billed for air ambulance transportation. However, fully insured health models would be subject to this mandate, which could increase premium costs for participants enrolled.
According to the MIA, coverage was required for non grandfathered individuals with health benefit plans. The federal Patient and Affordable Care Act requires that non grandfathered health plans must cover 10 health benefits including emergency service transportation by ground, water and air.
MIA advised that the bill should have established a new mandate for the large group market of non grandfathered health coverage plans. The Department of Budget and Management advised that the State Plan be self-insured for its medical contracts and would not be subjected to this mandate.
Robertson stated that she was only speaking on behalf of the Maryland league of Life Insurers to help keep the balance. They still want to see their patients protected from the balance bill and they are happy to continue to be a part of that solution. They just do not believe that HB 1376 strikes the right balance on that issue.