BISMARCK, N.D. - North Dakota Insurance Commissioner Jon Godfread is urging Congress to pass legislation protecting patients from air ambulance balance bills.
This happens when a company is out of network with a person's insurance. A balance bill is when a company sends the patient a bill for the costs not covered by the out-of-network reimbursement.
For example: if a flight cost $100,000 and the company wasn’t in-network with a person’s insurance, they’d be reimbursed based on the average of in-network rates. If that average was $50,000, the company could bill the patient for the remaining $50,000.
From 2013 to 2017, 32 patients complained to the insurance department about air ambulance bills, totaling $1.77 million in uncovered charges. That’s an average of $55,341 per complaint.
“So you've got consumers who have health insurance, have done everything right and due to no fault of their own or a choice they're not making, are getting an $80,000 bill on the back-end because of who the EMT called to pick them up. It's really unfair,” said Godfread.
The state is currently waiting for a date in front of the 8th Circuit Court of Appeals to hear a case whether to uphold North Dakota's 2017 law, which sets the reimbursements at the average of in-network rates.