MYRTLE BEACH, SC (WBTW)- News13 is tracking changes following our special report on sky-high air ambulance bills. It’s a deregulated industry that’s hurting some local families.
Air Methods, the air ambulance company at the center of our special report, left patients with crippling out of pocket cost. After the News13 story, Air Methods reached a deal with Blue Cross Blue Shield South Carolina and are in network. They said the average out of pocket cost for patients now in South Carolina is less than $50.
In-network patients will only be responsible for their insurance’s mandated co-pay and deductible.
If you’re out of network or billed before going in-network, you’re still hit with a sky-high bill like the Johnson family. Their 10-year-old son was in diabetic ketoacidosis, or DKA, and lost 10 pounds in just 24 hours.Doctors told them he had to be flown to MUSC in Charleston immediately, and after a 45-minute flight, they were hit with a $67,000 bill.
“Of the $67,499, my insurance company paid them $36,000 dollars,” said Amanda Johnson.
They still had to pay $30,000.
“I started getting message after message after message in Facebook messenger that went like this; be careful, the wolves are at your door,” said Johnson.
News 13 found Air Methods was suing several people in Horry County for debt collection, and the company was being sued in other areas of the state and the country.
News 13 started getting answers from Med-Trans, another air ambulance company that serves the Carolina’s and operates MUSC’s helicopter service.
According to study, the cost per transport ranges from $4,000 to $20,000, with an average cost of $11,000.
According to consumer reports, prices have spiked with air ambulance companies increasing charges from an average of $13,000 in 2007 to $50,000 in 2016.
Henry Ward said the cost of operations has gone up with no increase in reimbursement.
“We’re already behind the 8 ball because Medicare pays well below cost and Medicaid pays even more below the cost of operations so there is a cost shift to the commercial insurance, unfortunately,” said Henry Ward, Regional Business Director Med-Trans.
News 13 asked if that’s fair.
“The last thing we want to do is burden someone especially in their time of need. What we tell people is if you communicate with us, we’re going to work with you. I know a lot of people say this to say it, but we truly have a compassionate billing process,” said Ward.
A class-action lawsuit against Med-Trans filed in 2017 claims their prices are 300 times higher than other emergency transport companies.
Ward said they are not the industry leader in pricing, and often write off unfunded flights.
Med-Trans said they are in-network in other states like Tennessee and Virginia and are working to negotiate in South Carolina.
“In some states where we aren’t able to go in-network it’s typically because we can’t get a reasonable conversation with insurance companies about what our cost are,” said Ward.
Med-Trans said price caps would be detrimental and could lead to base closures industry-wide.
“You’re trying to negotiate something that’s decided at a federal level as a common Joe citizen and that’s not fair,” said Scott Johnson.
The Johnson’s fought back and only paid $800 instead of $30,000. They have tips for others in the same situation
“Contact a lawyer that can address, contact, and handle all communications. Number one just don’t try to do that alone,” said Johnson.
They said there’s a short window of time but appeal to your insurance company.
They said to not set up a payment plan before contacting an attorney because once you do, you’re locked in, and to make sure health insurance checks are sent directly to you and not the helicopter company to use as leverage.
However, for Johnson, a line in the consent form she signed waived that right.
“Once I got that e-mail and that print out of that zero dollar balance I celebrated a victory in the sense that I’m glad that we weren’t taken advantage of, and we had somebody point us in the right direction,” said Johnson.
The class-action lawsuit filed against Med-Trans was dismissed a year later due to a federal law that deregulates the price and routes of air ambulances
Some local lawmakers are hoping Congress can change that.
Representatives Kevin Hardee and Jeff Johnson sent a resolution to Congress urging them to allow South Carolina the ability to regulate how air ambulance carriers are reimbursed and make information easier to understand.
Congressman Jeff Duncan responded to the resolution in a letter to Rep. Hardee and said, “Price gouging in the air ambulance industry in an unfortunate practice that affects those in their most desperate time of need.”
Duncan said he will carefully review the findings and recommendations of the Advisory Committee for Transparency in the Air Ambulance industry when evaluating appropriate legislative action.
