August 02, 2019

Payors Continue to Challenge Air Ambulance Charges

Recently, the US Court of Appeals for the 8th Circuit upheld the lower court’s decision in Air Evac EMS, Inc. v. USAble Mutual Insurance Company.  In this case, Air Evac EMS, Inc. provided air ambulance services to a BCBS of Arkansas Member.  In 2014, Air Evac had average billed charges of $30,000 for air transportation services.  BCBS of Arkansas was paying between $1,000 and $5,000 for such bills.  As such, Air Evac filed multiple unjust enrichment claims against the payor related to payment. The District Court ruled in favor of BCBS of Arkansas.  Air Evac appealed to the 8th Circuit, who affirmed the decision for a variety of reasons, including that BCBS was not unjustly enriched because they provided the services pursuant to the plans they charged their clients, which rates included limitations on the amount of claims paid to air ambulance companies.