The larger fight over healthcare reform has as much to do with information as it does with access to treatment.
A new state law that goes into effect March 1 will inform consumers of their options and possible cost of being transported by an air ambulance during a non-emergency medical situation.
A federal investigation found that the average price charged for helicopter air ambulance service doubled between 2010 and 2014, climbing from around $15,000 to about $30,000.
Constituents have complained of bills as high as $45,000 for being transported via air ambulance, usually a helicopter, said state Sen. Jeremy McPike, D-29th District.
The law aims to provide patients in non-emergency situations or their designated representative with important information before they are transported by air ambulance.
“We need to start to really build a format that helps inform consumers and ask the doctors ‘What is this going to cost?’” he said.
The law will require hospitals or other health care providers to inform patients in non-emergency situations that they have an option between air ambulance and ground ambulance. The patient must sign the notice, which will also inform patients they will be responsible for charges incurred if the air ambulance provider is not in their health insurance plan network.
Finally, the notice will provide patients with an estimate of the range of charges for out-of-network air ambulance transport in the area. The law directed the Office of Emergency Medical Services with the Virginia Department of Health to develop a process for disclosing cost estimates by Jan. 1.
When air transportation service providers don’t have contracts with hospitals, patients can be surprised with a huge bill, McPike said, adding that pricing transparency is important in non-emergency situations where the patient can choose ground ambulance or can request a list of in-network air ambulance providers.
“[The law] gets the discussion going so [patients] can understand the costs involved and what alternatives are available to them,” McPike said.
A spokesperson for PHI Air Medical, a national company that has helicopter bases in Manassas and Fredericksburg, said in a statement that alignment among healthcare systems in the state will help ensure the company can provide lifesaving care to patients when needed. The national company serves 30,000 patients annually out of 65 bases nationwide, according to its website. The company says it has a crew of pilots, nurses and communications specialists at each base.
“Our commitment to providing the safest, highest level of care will never waver,” the company’s statement read. “We are called to transport and care for patients in significant need. These patients are flown because a physician or EMS professional has determined that it is medically necessary. We have a legal obligation to respond in these situations, without knowing of a patient’s ability to pay. Our primary concern in these moments is the safe transport and critical care for the patient in need.”
The new law is based on Senate Bill 668 introduced by McPike and House Bill 778, which was introduced by Del. Margaret Ransone, R-99th District, and Del. Robert Orrock Sr., R-54th District.
In 2017, Ransone introduced House Bill 1728, which was passed and directed the state department of health to create a work group to study the regulations, dispatch and billing procedures of air ambulance transportation services in the state and make recommendations by Dec. 1, 2017.
The report noted that federal law — specifically the Airline Deregulation Act enacted in 1978 — means the federal government cannot regulate the airline industry’s fares or routes, among other things. That also means states cannot regulate the price, route or service of the airline industry, including medical air transportation, according to the group’s report.
The group reported that there were 7,815 air medical transports in Virginia in 2016. Of that number, 66 percent were flights between facilities and 34 percent were flights from a scene.
Doug Gray, executive director for the Virginia Association of Health Plans, said he’s hopeful this new law will help consumers.
“It may be that some of them choose not to take the transportation offered to them and do something else that works for them,” he said. “They may find out that the transportation they were offered is not the best option for them, because it’s not in network.”
It’s not reasonable to fly someone between medical facilities without informing them of a potential $30,000 to $40,000 bill, said Gray.
The new law is a “good start” to protect and inform consumers so “they can decide for themselves what they want to do,” he said.
He stressed that the law applies to nonemergency situations.
“It’s a good start in helping people to at least have an opportunity to have some control over what happens to them when it’s not an emergency situation,” he said.