North Dakota Passes Law Regulating Air Ambulance Bills

May 1, 2017

The North Dakota Legislative Assembly passed and Gov. Doug Burgum has signed a measure that regulates how air ambulance services in North Dakota are paid by insurers.

Insurance Commissioner Jon Godfread praised the signing of Senate Bill 2231, which also requires hospitals to notify patients in non-emergency situations which air ambulance providers have a contractual agreement with the patient’s health insurance company, according to the state insurance department.

Air ambulance patients are often faced with unexpected and outrageous bills for the full cost of the flight or the balance left after a partial payment is made by the patient’s insurer, a practice known as “balance billing,” Godfread said.

Insurance does not cover the cost of an air ambulance when the ambulance provider does not have a contract with the patient’s health plan, even if the patient is one of the 88 percent of North Dakotans who have health insurance.

“It’s important to know that these lifesaving flights often come with life-altering bills, and what is most frustrating to the Insurance Department is that many of the complaints we receive are from people who have insurance, have been responsible, and through no fault of their own, are facing insurmountable balance bills from an air ambulance company,” Godfread said.

From 2013 through January 2017, the department received 28 complaints totaling $1.66 million in charges for air ambulance services, excluding one case in which the total for services rendered is unknown at this time.

Based on these complaints, each air ambulance ride has cost the consumer $59,287 on average. North Dakotans have reported being billed amounts ranging from $75 to $66,597, according to the insurance department. The numbers don’t include the hundreds of complaints that have been made directly to insurers regarding air ambulance services.

“It is important to protect citizens in critical medical situations from unexpected high costs beyond what insurance covers,” Lee said. “It also is important to keep this issue visible to the federal government,” said Sen. Judy Lee (R-West Fargo), the bill’s primary sponsor

Air ambulance services are also used for inter-hospital transfers when a patient requires treatment at a different facility. According to Godfread, it was common sense to add a requirement for hospitals to notify patients in non-emergency situations which air ambulances have contractual agreements with the patient’s insurance company to the bill.

The “legislation strikes a balance between ensuring we have these services in our state, while at the same time protecting our consumers from bankruptcy,” Godfread said in the department’s release.

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