Christine Jordan Sexton
A North Florida federal judge on Wednesday issued a final order dismissing a challenge to a 2020 law banning non-contracted air ambulance providers from “balance billing” insured patients.
Balance billing is a practice providers use to charge a patient the balance of bill not paid by insurance, and it can cost those left on the hook tens of thousands of dollars.
Air Methods Corp. and Rocky Mountain Holdings LLC filed the suit.
Florida Association of Health Plans President and CEO Audrey Brown, one of the lobbyists who pushed for the law, hailed Wednesday’s ruling.
“Florida is the only state in the nation to find a legislative path forward, that has been upheld time and again by the court system, to ban air ambulances from balance billing Floridians, an anti-consumer practice that burdened our state’s families,” said Brown, whose organization represents commercial, Medicaid and Medicare health insurers and managed care organizations across the state.
Insurers claim commercial payers are being overcharged by air ambulance providers to make up for low reimbursement rates from the federal government in programs like Medicare and Medicaid.
Air Methods Corp. did not immediately respond to Florida Politics’ request for a comment on the judge’s ruling.
The 2020 law addresses balance billing disputes in instances when there is no contract between the air ambulance provider and the insurance company. Florida Blue presented lawmakers with data during debate on the proposal that showed it routinely received bills in the $30,000 to $40,000 range for air ambulance rides under 50 miles. In some cases, Florida Blue testified at the time, it had seen air ambulance companies file liens against patients’ homes for unpaid ambulance bills.
The law requires air ambulance providers to accept as payment in full a “reasonable reimbursement” from the insurance company or HMO and any required co-payment or coinsurance or deductible from the insured patient.
“Reasonable reimbursement” is payment that considers the direct cost of services provided, costs incurred by the operation of an air ambulance service by a county, which operates entirely within a designated area of critical state concern as determined by the Department of Economic Opportunity, and in-network reimbursement for comparable services.
