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CONCURRENT RESOLUTION ON AIR AMBULANCE

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PROVIDERS

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2017 GENERAL SESSION

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STATE OF UTAH

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Chief Sponsor: Wayne A. Harper

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House Sponsor: Paul Ray

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8     LONG TITLE
9     General Description:
10          This concurrent resolution of the Legislature and the Governor urges Congress to
11     authorize states to regulate air ambulance billing and collections of patient care costs.
12     Highlighted Provisions:
13          This resolution:
14          ▸     urges the United States Congress to amend the Airline Deregulation Act of 1978 to
15     authorize states to regulate air ambulance billing and collections of patient care
16     costs.
17     Special Clauses:
18          None
19     

20     Be it resolved by the Legislature of the state of Utah, the Governor concurring therein:
21          WHEREAS, the Airline Deregulation Act of 1978 declared that "States may not enact
22     or enforce a law, regulation, or other provision having the force and effect of law related to a
23     price, route, or service of an air carrier";
24          WHEREAS, as many rural hospitals have recently closed, air ambulance services have
25     become increasingly necessary and are being used more frequently to transport patients to
26     faraway hospitals in an emergency;
27          WHEREAS, over the past decade, many states are reporting that some air ambulance

28     providers are not affiliated with a hospital and refuse to contract with an insurance carrier;
29          WHEREAS, this creates numerous situations in which air ambulances are being called
30     to airlift individuals in emergency situations and are billing these individuals for
31     out-of-network charges;
32          WHEREAS, these charges can cost patients tens of thousands of dollars out-of-pocket
33     when companies do not accept a patient's insurance;
34          WHEREAS, emergency patients rarely are in a position, or have the capacity, to choose
35     their own air ambulance carrier;
36          WHEREAS, some air ambulance carriers refuse to reveal actual costs to insurers, and
37     some insurers are unwilling to pay billed charges for the service;
38          WHEREAS, for ground ambulance services, the Patient Protection and Affordable Care
39     Act protects consumers from higher cost-sharing requirements for out-of-network providers
40     and states can protect consumers from balance billing;
41          WHEREAS, in the case of air ambulances, however, the federal cost-sharing
42     protections are only applied when the service is affiliated with a hospital and is considered an
43     extension of the emergency room service;
44          WHEREAS, federal government Medicare reimbursements cover only a small portion
45     of the actual cost of an air ambulance, forcing air ambulance companies to charge patients
46     more;
47          WHEREAS, although the Airline Deregulation Act of 1978 was intended to increase
48     competition, reduce rates, and improve airline passenger service, competition among air
49     ambulance providers has the opposite effect;
50          WHEREAS, the air ambulance industry has high fixed costs, including aircraft, pilots,
51     and trained medical staff;
52          WHEREAS, increased competition forces these costs to be recouped from a smaller
53     number of flights, leading to higher prices;
54          WHEREAS, various states have attempted to pass laws to protect consumers from
55     out-of-network air ambulance bills, but courts have determined that these laws are preempted
56     by the Airline Deregulation Act of 1978;
57          WHEREAS, the Airline Deregulation Act of 1978 should be amended to allow states
58     flexibility to protect consumers from excessive out-of-network charges by regulating how air

59     ambulance carriers are reimbursed, participate in networks, balance bill, and make information
60     transparent to consumers; and
61          WHEREAS, states should be given the authority to regulate air ambulance billing and
62     collections of patient care costs in order to protect patients from overwhelming financial
63     burdens for emergency medical services:
64          NOW, THEREFORE, BE IT RESOLVED that the Legislature of the state of Utah, the
65     Governor concurring therein, urges the United States Congress to amend the Airline
66     Deregulation Act of 1978 to authorize states to regulate air ambulance billing and collections
67     of patient care costs.
68          BE IT FURTHER RESOLVED that the Legislature and the Governor urge the United
69     States Congress to pass this amendment to protect patients from overwhelming financial
70     burdens for emergency medical services.
71          BE IT FURTHER RESOLVED that a copy of this resolution be sent to the Majority
72     Leader of the United States Senate, the Speaker of the United States House of Representatives,
73     the United States Department of Transportation, the Federal Aviation Administration, the
74     National Conference of State Legislatures, and the members of Utah's congressional
75     delegation.






Legislative Review Note
Office of Legislative Research and General Counsel