James W. Ferrell of Drew County was shocked to receive a $29,000 bill from an air ambulance operator for his 41-mile trip to a hospital in late 2015.
Ferrell now is challenging the bill by Air Evac EMS Inc. of O’Fallon, Missouri, in a lawsuit seeking class-action certification in Drew County Circuit Court.
The “outrageously high prices … bear no reasonable relationship to the services rendered,” Ferrell said in the lawsuit filed by his attorney, C.C. Gibson III of Monticello.
Air Evac took Ferrell from Bradley County Medical Center in Warren to Jefferson Regional Medical Center in Pine Bluff when he was experiencing chest pain in November 2015. According to his suit, Air Evac said Medicare would have paid $6,272 for the ride.
Air Evac’s attorney, Henry Quillen of Portsmouth, New Hampshire, told Arkansas Business last week that the company is evaluating Ferrell’s complaint. But he also said the issue of the fees is related to his company’s pending lawsuit against Arkansas Blue Cross & Blue Shield.
Ferrell was covered by ABCBS, which will pay no more than $5,000 for air ambulance service. In Ferrell’s case, it paid $1,000 on the $30,000 bill, leaving him responsible for the balance.
Quillen said Air Evac has tried to get into the ABCBS network to provide the air services to its members for an agreed-upon fee. But, he said, the insurer has refused to offer contracts to providers of air ambulance services.
Last year, Air Evac sued ABCBS in federal court in Little Rock, claiming it is owed $10 million or more for medical flights provided to policyholders.
Air Evac also wants a judge to rule that the cap ABCBS places on air ambulance reimbursements violates the Affordable Care Act’s essential health benefits requirement.
An ABCBS spokeswoman told Arkansas Business in May that she couldn’t comment on the specific claims in the lawsuit. “We do believe the complaint is incorrect in its assertion regarding annual limits on air ambulance services since individual policies purchased prior to the implementation of the Affordable Care Act may indeed have such annual limits,” ABCBS said.
ACA “also does not require any minimum payment requirements, nor does it contain any network adequacy requirements with regard to air ambulance services. Thus, we believe those assertions are incorrect as well,” the insurer said.
The federal case is on hold while the Arkansas Supreme Court settles a related question of law related to the Arkansas Deceptive Trade Practices Act.
‘No Valid Contract’
Ferrell’s lawsuit argues that he had “no valid contract” with Air Evac before he was transported that makes him responsible for the bill.
Quillen disagreed, saying an implied contract was in place.
Still, a dispute about the price would have to be settled by the U.S. Department of Transportation, he said. The Airline Deregulation Act of 1978 prevents states from regulating the cost of air carrier services, Quillen said.
Ferrell said that without the information on pricing, patients don’t know if they should use Air Evac’s services, a competitor or be transported by ground. Ferrell’s lawsuit says he would have arrived at the Pine Bluff hospital sooner if he had used a $1,500 ground ambulance.
Ferrell said that Air Evac knows patients are on the hook for the remainder of the bill that ABCBS won’t pay. Air Evac “nevertheless conceals, suppresses or omits this important and very material information from patients until after it has transported them,” the lawsuit said.
Seth Myers, the president of Air Evac, told Arkansas Business last year that each transport it makes in Arkansas costs about $30,000.
He said the prices are high because of the high cost to operate an air ambulance. The aircraft alone costs about $3 million, and the modifications add about $500,000 to the purchase price. Maintenance costs can be more than $200,000 annually. In addition, Air Evac has at least four pilots and medical personnel on standby at all times.
Ferrell wants his case to be certified as a class action and is seeking an unspecified amount of damages that include violations of the Deceptive Trade Practices Act.
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