The new federal law banning surprise medical bills does not do as good a job protecting people from unexpected bills as traditional Medicare–which does not allow them at all. It simply keeps out-of-network doctors, hospitals and air ambulances from charging patients directly for services they receive, over which they have little if any control. But, it doesn’t stop out-of-network ground ambulances from charging people a small fortune for their services. Why doesn’t it?
Of all the surprise bills people receive, ambulance bills are particularly common. By some accounts, more than seven in ten ambulance rides are out of network. And, the average cost to patients for the service is $450. But, even though these costs keep people from calling 911 in a health emergency, members of Congress could not bring themselves to ban out-of-network bills for ambulance services.
Part of the issue, according to the New York Times, is that federal lawmakers did not want to take on local lawmakers who are often responsible for allowing these ambulance bills. Many ground ambulances are run by municipalities that need the money they receive for out-of-network services, particularly given the economic devastation Covid has wrought.
High private ambulance charges are common. But, public agencies that provide ambulance services appear to be as bad as private ambulance companies at sending out surprise bills. In a given year, patients owe around $129 million for ambulance services.
Members of Congress also apparently felt that they did not know enough to regulate ambulance companies. For example, there is little information on what it costs to maintain an ambulance. They did not want to act rashly, perhaps thinking that they would drive ambulance companies out of business.
Many states that are regulating surprise bills do not yet regulate ambulance services. Shockingly, in Texas, 85 percent of ambulance services are out of network. City-run ambulances do not have contracts with health insurers. In Colorado, private ambulances cannot issue surprise bills; but, they can charge as much as 3.25 times Medicare’s rate for ambulance services. Public ambulances can send out surprise bills, allegedly because the fire chiefs who often provide ambulance services lobbied against having the fire departments’ bills regulated.
Instead of banning surprise ambulance bills, Congress established a commission to examine and report back information about ground ambulance services and bills. Traditional Medicare pays a regulated rate for ambulance services. It plans to collect more data on ambulance costs and share it.
Here’s more from Just Care:
- New law prevents doctors and hospitals from sending patients surprise medical bills
- New Medicare rule requires insurers to tell people their out-of-pocket drug costs before they fill a prescription
- Plan ahead for a hospital visit: Talk to the people you love about these seven important items
- Choose your hospital emergency room carefully
- Advice A to Z
