Florida consumers said they have been slammed with ambulance charges. But the issue remains unresolved because ambulances were exempted from a bill passed last spring to limit surprise medical bills, according to The Palm Beach Post.
The consumers report facing out-of-pocket charges of $1,000 or more for ground ambulance rides and more than $37,000 for air rides during the last three years.
The problem largely stems from balance billing, which is the practice of billing a patient for an outstanding balance after the insurance company submits its portion of the bill.
Florida Gov. Rick Scott (R) in April signed a bill banning surprise medical charges. Under the bill, consumers cannot be charged more than the equivalent of in-network charges in emergencies and at other times where the patient has no real choice — such as an out-of-network anesthesiologist for a scheduled procedure at an in-network hospital, according to the Palm Beach Post. However, the bill exempts ambulance services.
Due to the exemption, when ambulance companies and insurers don't agree on an appropriate charge, the consumer is left paying the difference.
A panel of healthcare industry representatives and consumer advocates, convened by Florida insurance consumer advocate Sha'Ron James, plans to search for possible solutions over the next year in regard to ambulance services, which typically don't join insurer networks, according to the report.
States may be limited in their ability to regulate prices on air travel including ambulances due to federal rules, the report notes, but Wences Troncoso, vice president and general counsel for the Florida Association of Health Plans, said a potential ban on balance billing by ambulances could protect consumers without directly setting prices and provide some incentive for ambulances to join networks and negotiate prices.
But ambulance providers have expressed concerns that insurers want to set reimbursement far too low, according to the report. They argued that local taxes might have to rise and services may have to be cut if ambulances, most of which are operated by counties and cities, could not charge out-of-network rates.
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