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Consumer Protection Legislation Regarding Air Ambulance Billing Now in Effect

BISMARCK, N.D. – Insurance Commissioner Jon Godfread today reminded North Dakota consumers that the new state law regulating how health insurance companies pay out-of-network air ambulance claims became effective Jan. 1, 2018. The law, signed by Governor Doug Burgum in April 2017, is designed to protect consumers from massive, unexpected air ambulance bills.

Air ambulance has become a more frequently used mode of transport for individuals needing medical care. Often these patients are faced with massive and unexpected bills for the full cost of the flight or the balance left after a partial payment is made by the patient’s insurer, a practice known as “balance billing.” Insurance does not cover the full cost of an air ambulance when the air ambulance provider does not have a contract with the patient’s health plan.

“Historically, these flights have often been followed by life-altering bills regardless of whether the patient has health insurance,” Godfread said. “Many consumers we’ve heard from did not have the option or ability to choose their provider because of the circumstances. Instead, a third party chose their air ambulance service and now the consumer, through no fault of their own, is left facing bankruptcy. The Department has worked tirelessly during the last two legislative sessions to protect our consumers from this outrageous practice. This hard work has finally come to fruition through our ability to regulate how insurance companies pay claims.”

From 2013-2017, the Department has received 34 complaints totaling $1.86 million in charges for air ambulance services, excluding one case in which the total for services rendered is unknown at this time. Based upon these complaints, each air ambulance ride has costed the consumer $54,705 on average. Consumers in North Dakota, have reported being billed amounts ranging from $20,000-$66,000. However, these numbers don’t include the hundreds of complaints that have been made directly to insurers regarding air ambulance services.

Every health insurance plan sold in North Dakota is required to have this protection for North Dakota Consumers. Prior to paying any bills to an air ambulance company, consumers should reach out to their insurance company or to the Insurance Department at (800) 247-0560 for assistance.

Air ambulance services are also used for inter-hospital transfers when a patient requires treatment at a different facility. Consequently, state law requires hospitals to notify patients in non-emergency situations which air ambulance providers have a contractual agreement with the patient’s health insurance company. As this portion of the law was effective on Aug. 1, 2017, the Department created a one-page document illustrating which air ambulance providers are in-network with the three health insurance carriers in North Dakota. This information is available to consumers and health care providers, and must be made available to patients prior to being transported by air ambulance in a non-emergency situation. The document can also be found on the Department website at  www.nd.gov/ndins.











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