The Department of Health and Human Services, Internal Revenue Service, and Department of Labor are proposing that air ambulance providers provide certain cost information and claims data
On September 16, 2021, the above federal agencies proposed rules requiring that air ambulance providers provide certain cost information and claims data as is required by the No Surprises Act. The proposed rules also include an HHS-only proposed rule that sets forth civil money penalties for providers that fail to submit the requested data. The agencies suggest that these rules are required because air ambulance services frequently result in surprise medical bills due to individuals’ inabilities to select an in-network provider of air ambulance services when faced with an urgent medical situation. Because of low network participation rates by providers of air ambulance services, individuals are also unable to avoid potential higher cost sharing and balance billing by outof-network providers. When individuals are unable to avoid providers or providers of air ambulance services that are not in their plan’s network, it raises health care costs and exposes individuals to financial risk.
The rule will require providers of air ambulance services to submit data regarding air ambulance services on a calendar year basis. Air ambulance providers will have to supply cost data separated to the maximum extent possible by air transportation costs and costs of medical services and supplies associated with furnishing air ambulance services; the number and location of all air ambulance bases; the number and type of aircraft operated by the provider; the number of transports by payor mix (including plans, issuers, government payors, and the uninsured); the number of claims denied by group health plans or health insurance issuers and the reasons for denials; and the number of emergency and nonemergency transports by base and by type of aircraft.
The comment deadline is October 18, 2021.