A stroke patient who received a $42,000 air ambulance bill was asked to sign a nondisclosure agreement after the bill was reduced, according to the The Clarion-Ledger.
Here are nine things to know:
1. After suffering a stroke, Jack Wayne took an air ambulance from Forrest General Hospital in Hattiesburg, Miss., to University of Mississippi Medical Center in Jackson. Private air ambulance company Med-Trans, which is out of network with Mr. Wayne's insurance, provided the 90-mile transport.
2. Mr. Wayne told The Clarion-Ledger he was then hit with a $42,000 helicopter bill, including a base rate, as well as a charge per mile. The bill was $37,000 after payment from his insurance company, Ambetter. Ultimately, Mr. Wayne was able to reduce the bill to just under $17,000 through negotiations. But once that happened, Med-Trans asked him to sign and return a nondisclosure agreement indicating he would not discuss his "discount," according to the report.
3. A Med-Trans statement regarding the nondisclosure agreement states: "Under HIPAA, we are prohibited from discussing the particulars of any patient transport, and we merely seek the same from patients."
4. Mr. Wayne's situation, which other people have experienced, centers on balance billing. Balance billing occurs when air ambulances charge an amount for their services, and patients are put on the hook for costs not covered by insurance.
5. Federal law doesn’t help the issue. Under federal law, air ambulances are considered air carriers and have few restrictions on the amount they can charge for rides, reports Bloomberg. This means state healthcare billing regulations, such as Mississippi's law to address balance billing, typically do little to lower air ambulance costs.
6. The Clarion-Ledger said proposed changes to federal law are in the works. Meanwhile, though, those in the air ambulance industry contend their prices are necessary. Ken Grimes, Med-Trans vice president of business development, told The Clarion-Ledger his air ambulance must make up for unfunded or underfunded patients by charging privately insured patients more than $28,500.
"The problem we have in Mississippi is commercial insurance not paying their fair share for people that have signed up and are paying a premium every month," Mr. Grimes said.
7. While the air ambulance industry argues part of the problem stems from insurers not agreeing to network contracts, consumer groups and insurers argue air ambulance companies remain out of health plan networks for their own financial gain, reports Bloomberg.
8. Mr. Wayne went through a complaint process regarding his bill and would not pay. However, he and his wife eventually decided to pay to avoid negative effects on their credit, according to The Clarion-Ledger.
9. Some people are paying for air ambulance memberships to avoid high medical expenses. In certain instances, air ambulance providers also are part of contracts that allow them to serve certain areas with no additional out-of-pocket costs to patients. That was not an option for Mr. Wayne based on where he lives.
Read more about the issue and Mr. Wayne's circumstances in The Clarion-Ledger.
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