Surprise Billing Ban Hits Air Ambulance Providers

Surprise Billing Ban Hits Air Ambulance Providers


In a move to fight back against the No More Surprises Act, an air ambulance provider is suing the federal government over the rules the law implements. The act is a law that was put in place at the beginning of this year meant to protect consumers from price gouging, and unexpected bills, when they are unknowingly treated by out of network providers. LifeNet, an air ambulance provider, is suing the federal government for the rules the law implements.

Life Net is a Texas based air ambulance that has air bases in 3 states, which also include Arkansas and Louisiana. They have operated for 40 years, and claim to have transported more than 15,000 patients in their Bell 407 Helicopters, and have also provided nearly 3 decades of ground emergency medical services. Needless to say they are your all around ambulance service, standing to lose millions in profit if the enforcement of the No Surprises Act is enforced. Non-compliance will also only bring fines, which is not good for business or profit margins.

The main issue LifeNet has with the law is the guidance the federal government has provided to third-party arbitrators. At the beginning of the year new guidelines were put into place to shield patients from surprise billing, and price gouging. Both very common tactics used by medical providers when patients are deemed out-of-network. Part of the law allows payers and providers to enter into arbitration when they cannot agree on reimbursement for medical services, as a last resort to settle a debt. Medical providers have taken advantage of Americans for as long as the company has existed with surprise billing, and out of network price gouging.

LifeNet claims that the implementation of the law with its arbitration process specifically tips the scale to favor the payer, and not the provider, when settling debt the way congress currently wrote the law. The part of the law which bothers LifeNet, and medical providers, most is that the federal government has instructed arbitrators to assume that the qualifying payment amount (QPA) is the correct payment amount. What is the QPA you ask? It is the median in-network rate or the average negotiated rate that LifeNet has with providers. A secret rate that the company has negotiated with providers, and not so happy to disclose, even those it the law that they should be. Providers claim that doing this will set a ceiling on what they can charge when price gouging out of network patients.

Recently a federal judge sided with providers, and struck down this rule. LifeNet is still continuing with a lawsuit, claiming that air ambulances are still being held to the presumptive QPA. In an effort to once again get their way, and continue price gouging patients who have no say or knowledge of pricing (which in 2020 was an average of $30,446) they have asked to have their case switched to the same federal judge that struck the rule in their favor in the last ruling. 

The Department of Justice is appealing the ruling, but only time will tell if companies like this, along with hospitals, will continue to blindly charge patients without repercussions. The only way companies like LifeNet will be held accountable is by forcing them into transparency with legislation and consumer demand for the knowledge of cost up front. 

Let us show you how to make providers accountable for price gouging with advocacy. To find out the simple way you can avoid medical debt, and know the price of what going to the doctor upfront, call an advocate at MediShield today! MediShield is one of the best steps you can take to learn how to become a consumer of your healthcare and not a victim. Learn how to shop smarter for healthcare with MediShield today!