The Coalition Against Surprise Medical Billing continues its four-part blog series to provide a deeper analysis of everything you need to know about the No Surprises Act. In our third blog of the series, we explain the role of some private-equity firms in exploiting patients and attempting to weaken the No Surprises Act. We’ll also look at why this law passed in the first place as we examine several cases of patients who experienced financial harm as a result of the price-gouging practices of air ambulance companies.
Eight lawsuits filed by various physician groups, air ambulance companies, and even an individual doctor threaten to weaken implementation of the No Surprises Act. These groups want to send even more claims to a costly and burdensome arbitration process which will drive up health care inflation and likely to lead to less network participation.
Unfortunately, the influence of private-equity firms is making health care inflation even worse – the last thing patients and health care consumers need. As hedge funds become increasingly involved in the health care sector, it is crucial the No Surprises Act remains in place to keep prices in check and put patient needs first.
Along with private-equity firms, air ambulance companies play a significant role in the practice of surprise billing. For years, out-of-network air ambulance rides resulted in unaffordable and sometimes bankrupting medical bills for patients. Research from Health Affairs shows that, between 2013 and 2017, air ambulance bills averaged $91 million per year. A GAO analysis found that out of more than 20,000 air transport services in 2017, the median price for helicopter transport was $36,400 and more than two-thirds of these transport rides were out-of-network.
Take the example of Bruce Williams, who faced a sudden medical emergency while vacationing in Jamaica. He returned to the United States via air ambulance, and in the panic of the moment, his wife was unaware she had signed a release form allowing the air ambulance to submit a claim for the trip. To their surprise, the coupled later received a nearly $20,000 bill, and it took months of negotiations to finally reach a conclusion for their medical saga.
Before the No Surprises Act, regulations or safeguards did not exist to prevent these outrageous medical expenses. Since the law was enacted, protections have helped limit cost-sharing for patients who need emergency medical transportation. Now, air ambulance companies are targeting the No Surprises Act regulations, because the law prevents them from using out-of-network billing to drive huge profits at the expense of patients.
Thankfully, the safeguards in the No Surprises Act currently limit harmful billing practices and ensure patients won’t be charged more than in-network cost-sharing for most services. The No Surprises Act was carefully designed – and supported – by Republicans and Democrats to ensure patients are not burdened by expensive, out-of-network medical bills. Recent data highlights the law prevented two million surprise bills in just the first two months of 2022. It is critical the No Surprises Act be implemented in full, and the lawsuits driven by private-equity-backed providers do not delay or overturn the patient protections included in the law.