The No Surprises Act (NSA) is designed to protect patients from surprise bills. Yet the NSA excludes ground ambulance charges even though at least one study found about half of these rides among privately insured consumers may result in a surprise bill.
The Ambulance Industry’s Complexity
Why would the NSA exclude ground ambulance charges? In a word, complexity.
Who operates and pays the costs of running an ambulance company varies by state and locale. Depending on where you live, your local ambulance provider may be run by the fire department, a government agency, hospital or private company.
Further complicating the situation, providers run by municipal and city governments may be subject to local and state laws in addition to any federal regulations.
Legislators drafting the NSA, already dealing with various industry lobbyists (think: pharmaceutical industry) and differing opinions within their own ranks, decided to toss this tangled mess to an advisory committee.
Advisory Committee’s Challenges
The advisory committee was appointed by members of the Department of Labor, Health and Human Services, and the Treasury. This committee was charged with reviewing and recommending options to protect consumers from surprise ambulance bills.
Based on my years of working with committees tasked with untangling a hot mess, I say, “Don’t expect a solution anytime soon.” Not only are three government agencies needing to coordinate their efforts, but there is not a lot of data as to what precisely goes into the high cost of ambulance transportation. Without those basic facts, it’s hard to come up with a meaningful solution.
In addition, it’s likely that federal or state legislative action will be required to actually implement any of the committee’s recommendations. That’s more time in which you run the risk of receiving a surprise bill for ground ambulance services.
The Current Landscape
Since you won’t be getting relief from the NSA anytime soon, let’s take a look at the current states’ patchwork of regulations regarding ground ambulance billing.
These ten states have created their own regulations to protect consumers from ground ambulance surprise bills:
- Colorado
- Delaware
- Florida
- Illinois
- Maine
- Maryland
- New York
- Ohio
- Vermont
- West Virginia
For more information on the scope of their regulations, check out this Center on Health Insurance Reform blog post.
Where This Leaves Consumers
First and foremost, if you are having a health emergency, call 911. Don’t let a potential ambulance bill cause you to avoid or delay care or emergency transportation.
Should you receive a surprise bill, here are some things you can do to try to reduce the bill:
- Ask your insurer to review a detailed claim along with your medical record and cover more of the bill.
- If you’re not satisfied with your insurer’s response, appeal it. You can find information on how to appeal a claim in your plan document.
- Ask the ambulance company to lower the bill. Ask for a payment plan if they won’t lower your bill.
For more information on how to potentially avoid surprise bills, check out my earlier post, 5 Health Care Choices You Can Make.
Have a Happy, Healthy Holiday Season! I’ll be back in the New Year.