A trade association representing air ambulance companies sued several government entities, including HHS, in an effort to halt a provision in the surprise-billing rule.
In the lawsuit filed Nov. 16, the Association of Air Medical Services state that the interim final rule adopted by HHS, the U.S.Treasury Department, the IRS and Labor Department unfairly favors health insurers and forces air ambulance providers to accept "deflated rates."
The trade association said it supports the goals of the No Surprises Act, such as removing patients from the middle of billing disputes, but argues that the independent dispute resolution process adopted by the federal agencies will have "disastrous consequences" for air ambulance companies.
In particular, the trade association's lawsuit takes issue with a metric that will be used in the dispute resolution process known as the qualifying payment amount, or insurer’s median in-network rate. The association said using this metric means that insurers will know exactly how independent dispute resolution entities will resolve the disputes, making open negotiation a forgone conclusion.
The association also said that insurers will leverage that qualifying payment amount against future payments, lowering both in and out-of-network payments to providers over time.
"The fair and transparent process that we all supported is not the process being implemented," said Cameron Curtis, the association's president and CEO. "Instead, we are faced with a scenario in which a patient is in an emergency, is transported by a helicopter at the request of a trained first responder or qualified physician, and that patient’s insurer gets to unilaterally determine the amount they pay. This will have disastrous consequences for access to emergency air ambulance services."