PRINTER'S NO. 1735
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE RESOLUTION
No.
337
Session of
2017
INTRODUCED BY PICKETT, MAY 18, 2017
REFERRED TO COMMITTEE ON INSURANCE, MAY 18, 2017
A RESOLUTION
Urging the Congress of the United States to enact legislation
that would allow states to regulate air ambulance billing and
pricing practices.
WHEREAS, On February 28, 2017, United States Senator Jon
Tester of Montana introduced S.471, the "Isla Rose Life Flight
Act," to preserve state authority to regulate air carriers
providing air ambulance service, rein in exorbitant air
ambulance costs and provide families with financial certainty
while they are facing life-threatening situations; and
WHEREAS, Air ambulances are specially equipped aircraft,
usually helicopters, which are used to ferry sick or injured
individuals in emergencies; and
WHEREAS, States are currently prohibited from regulating
nearly all transportation aspects of air ambulance operations;
and
WHEREAS, As the air ambulance industry has grown, so too have
complaints about costs and the lack of regulations; and
WHEREAS, States that have attempted to enact legislation or
promulgate regulations regarding air ambulances have been
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challenged with lawsuits that argue that air ambulances fall
under the Airline Deregulation Act (Public Law 95-504, 92 Stat.
1705), which prevents states from interfering with fares, routes
and services; and
WHEREAS, In March 2016, the United States District Court for
the District of North Dakota, permanently enjoined North Dakota
from enforcing a state law that established a primary call list
for air ambulance operators that became "participating
providers" with insurance companies in the state and that set a
fee schedule for reimbursement of air ambulance transportation
in cases managed by the state-run workers' compensation system,
thereby determining that the Airline Deregulation Act expressly
preempts the law as an improper regulation of an operator's
services and prices; and
WHEREAS, The Airline Deregulation Act was meant to increase
competition, reduce rates and improve passenger service, but
competition among air ambulance providers has resulted in the
opposite effect because the industry has high fixed costs,
including aircraft, pilots and trained medical staff; and
WHEREAS, In Pennsylvania, especially in rural areas, air
ambulance service is an essential asset in providing timely
emergency care; and
WHEREAS, Given the low reimbursement for Medicare and
Medicaid, the air ambulance industry is charging individuals
with private insurance an inflated price to make up the
difference; and
WHEREAS, According to industry data, more than 1,000 air
ambulances now operate in the United States, which is twice as
many as in 2000; and
WHEREAS, Four private air ambulance companies account for
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half of the industry's revenue; and
WHEREAS, According to Consumer Reports in April 2017, the
average charge from one air ambulance company rose from
approximately $13,000 in 2007 to $50,200 in 2016; and
WHEREAS, The average bill for air ambulance services within
the industry was $32,895 in 2014; and
WHEREAS, Rick Sherlock, the president and CEO of the
Association of Air Medical Services, a trade group, has stated
that many air ambulance patients are on Medicare or Medicaid and
that those programs pay $200 to $6,000 per transport; and
WHEREAS, The real cost of providing air transport averages
approximately $7,000, according to Jon Hanlon, founder of
Research 360, and an analysis by New Mexico's Office of
Superintendent of Insurance indicates that the costs average
approximately $10,000; and
WHEREAS, The Insurance Committee of the House of
Representatives of the Commonwealth of Pennsylvania held an
informational meeting on air ambulance costs and services in
April 2017 and received testimony from the Department of Health,
the Insurance Commissioner, air ambulance companies and an
insurer; therefore be it
RESOLVED, That the House of Representatives of the
Commonwealth of Pennsylvania urge the Congress of the United
States to enact legislation that would allow states to regulate
air ambulance billing and pricing practices; and be it further
RESOLVED, That the House of Representatives urge the Congress
of the United States to take favorable action on S.471; and be
it further
RESOLVED, That a copy of this resolution be transmitted to
the presiding officers of each house of Congress and to each
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member of Congress from Pennsylvania.
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