Capitol Hill lawmakers are focusing on surprise medical bills for hospital services and treatments, including air ambulance costs, which can sometimes surprise patients with bills of more than $36,000. CBS recently told the story of Joseph Penrod, whose son accidentally swallowed a bunch of prescription pills, prompting the family to try and get him to an ER quickly.
"The first thing that [my wife] did was call poison control. And they talked to her about getting him to an ER as quickly as possible. They suggested that they were not appropriately equipped to deal with that particular age of patient in that particular condition," Penrod said.
His son was stable at the time he arrived at the hospital and Penrod's insurance paid for the emergency room care. However, it failed to pay for the $40,000 that it cost to airlift his son to the hospital. "I did not have $40,000 laying around. It would've destroyed us financially," Penrod said.
These types of transport services are often out of insurance network coverages because the companies are independent contractors that negotiate their costs separately. They’ve become a lucrative business, making most money in rural areas.
Doug Gray, executive director of the Virginia Association of Health Plans said: "The air transport industry, the predominant players are driven by private equity. The model is very simple. There are people out there in an emergency, they have resources, and we can take them."
He continued: "An accident can happen any time, any place, and you could be the one who's having that decision made for you. And your livelihood, and your savings can be on the line."
A new law in Virginia that went into effect March 1 now gives patients the right to choose if they want to take an air ambulance in non-emergency situations and requires hospitals to disclose more cost information. Penrod spent over a year fighting the bill and finally offered to pay $1000 to settle it, which the company took.
He concluded: "If you're rich, you can get a lawyer and that's great. If you're on the lower end of the spectrum, then you need to be able to fight for long enough to figure out how to escape."