Come New Year and people will no longer need to fear balance billing when it comes to air ambulances. However, the general public is not entirely educated enough about the advantages that the No Surprises Bill brings to the table. Once it comes to effect on January 1, 2022, people will no longer be liable for any bills from air ambulances. It is designed to protect customers from exorbitant charges that are levied on them for exercising their right to live and get adequate healthcare. However, with the new bill coming into effect, there is bound to be some confusion and the potential for people to fall prey to unfair financial practices.
Support for Rights Knowledge
Customers are urged to know their rights by educating themselves thoroughly. Of course, there are going to be issued as to where one can find the right sources for doing so. One such guide has been presented by US PIRGS. The Department of Health and Human Services (popularly known as HHS) will have a dedicated helpline for consumers in this regard. Anyone can call this line to know more about the bill and also raise any complaints that they may have about air ambulances or medical practices in general from physician to hospital services. The scope must be limited to billing practices while doing so.
There is Opposition to the New Bill
Certain air ambulances, doctors’ associations, and hospital conglomerates are opposing the new bill. The primary reason that they are doing so is a strong belief that the new rules favor insurance companies. Their grouse is that insurance companies will arbitrarily be able to decide the payout for the medical services rendered. They also clarify that their intent is not to take away the advantage that the patients get but to create a fair playing ground with the insurance industry.
The No Surprises Bill is slated to come into effect soon. If all goes well, the bill will come into effect from the first month of next year. In this regard, the US air ambulance industry is preparing itself. This is especially so for organizations that are funded by private equity with the sole motive of profit. Survivability could be an issue for most small players in the industry. As with any other industry, the US air ambulance industry too may soon look at mergers to cut costs and increase efficiency. The primary reason behind this is an expectation that the payouts for the services are going to get thinner.
US Air Ambulance Acquisitions Cannot Be Discounted
For the big players with deep pockets, it is an opportunity to acquire the smaller ones to increase their reach. In this uncertain time for the US air ambulance industry, it would not be surprising that some of the smaller players start fearing bankruptcy. This is an opportunity for the biggies as they will surely get an upper hand in negotiations. The industry might soon veer towards oligopoly. In other words, it would not be surprising to see just a few organizations controlling the US air ambulance industry.
Rural Access to Air Ambulance Services
The No Surprises Bill has trained all its guns towards the pricing but not at the accessibility problems that may possibly result from fewer players in the market. It is noteworthy that the rural parts of America need air ambulances most but from a business point of view, they are the least profit-making. The result could be a lack of motivation for the US air ambulance industry to look at these areas. Of course, the government – through policy changes – can incentivize air ambulance services to look at these regions.
The No Surprises Act has got everyone talking these days. From the word go, there has been a feeling in the air ambulance industry that the regulation is going to go against it. Now, industry experts believe that the fear is turning into a reality.
The intent of the No Surprises Act is excellent. In that, it plans to exclude the patient from the picture when a payment dispute arises. In other words, when an insurance company refuses to cover the air ambulance cost in full, the burden of balance payments does not fall on the patient. It is for the insurance company and the air ambulance service provider to settle the financial differences between themselves.
The Air Ambulance Association Cites Problem with IDR
IDR stands for independent dispute resolution. It has been drafted such that insurance providers and healthcare providers (including air ambulance service providers) can hold discussions between themselves and come to a conclusion on payments. If not, they are free to approach an independent entity as defined by the No Surprises Act. However, one of the clauses set by Congress says that no single statutory factor must veer in any direction during IDR. However, the air ambulance association felt that the federal government was weighing heavily on a single factor and that is qualified payment amount or QPA.
The air ambulance association is of the opinion that the impetus solely on QPA will have disastrous consequences for the industry and also the people that it caters to. If the insurance providers are the sole authority on the payments that are to be made for medical flight services, it may prove detrimental to the industry. Ultimately, it will act as a disincentive to the air ambulance business. Many air ambulance service providers may be forced to shut their businesses.
Several federal agencies in the United States of America are now coming together to enforce the No Surprises Act. Thus far, the air ambulance industry has been able to charge the patients arbitrarily and the state governments have not been able to do anything about it. Now, this is all set to change with the federal authority weighing down on this issue. The main purpose of the act is to avoid any surprise billing or balance billing where the recipient of the service is liable to pay a part of the amount. The bill will come into effect next year and the hope is that people will no longer have to avoid healthcare due to the fear of high prices.
How will The Bill Affect Air Ambulance Cost?
People who come under Medicaid and Medicare are not liable to pay any out of pocket expenses. This is because the air ambulance companies are not allowed to send requests for payments to them. However, a large portion of the United States also relies on private health insurance. This is where the problem lies. With private insurances, the amount is only covered when a person uses in-network air ambulance services. Any service that is out of the network attracts a cost that is to be borne by the consumer.
The No Surprises Act Promises to Change Things
With the new No Surprises Act that is slated to come into effect in the year 2022, air ambulance companies will not be able to send requests for part or full payments to the consumers. Instead, they will have to make do with what the insurance companies disburse. If there is a dispute regarding the monetary compensation for the service, it will have to be arbitrated among the insurance providers and the air ambulance companies. The move will be a big relief for people seeking emergency air ambulance services.