Air ambulance companies have consumers in death grip

    Two years ago in this space, I told the story of a Mississippi woman, Katherine Green, who got caught in the unsavory business practices of the air ambulance industry that has trapped many more Americans since then. Green, a college history professor, chose to fight the company that transported her late husband to a Jackson hospital after he suffered a fatal fall in their home.
    The ambulance company Rocky Mountain Holdings, a subsidiary of Air Methods, billed her $50,950. Her husband’s insurance company, Blue Cross & Blue Shield of Mississippi, which administered the State and School Employees’ Health Insurance Plan, paid $7,192 of the $58,142 the ambulance billed. She was on the hook for the balance.
    Green’s retirement savings was in jeopardy. Alarmed, she took her case to Mississippi state officials and the media, which resulted in lots of publicity about her plight. In a recent phone call, Green told me, “I figured out from this, you have to contact everybody. The more inquiries you get out about your situation it eventually becomes too much trouble for them.”
    Mississippi does prohibit balance billing, which means once a seller of health care services accepts any insurance payment, they cannot bill patients for the remainder. However, the prohibition doesn’t apply to air ambulances, according to Roy Mitchell, executive director at the Mississippi Health Advocacy Group. “I think they do not like the publicity they’re getting, and that’s why they’ve left her alone,” he said, adding the company could still try to collect.
    In fact, Mississippi and other states have had a devil of a time trying to regulate air ambulances as the industry has grown from a few dozen helicopters in the 1980s, operated mostly by hospitals, to some 900 today. According to Bloomberg Business, wealthy investors and private equity groups control many of the newcomers in this profitable industry.
     The trouble regulating air ambulances stems from a 1978 law that deregulated the airlines. Under the Airline Deregulation Act, air ambulance operators are considered to be air carriers — like Delta and American — and the states have no power to regulate them. States have their hands tied and cannot regulate rates or their billing and collection practices.

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