Bill Seeks To Boost Medicare’s Reimbursement for Air Medical Flights

 - February 16, 2015, 3:25 PM

A bill introduced in the House of Representatives early this month would provide air medical providers with an immediate boost in the Medicare reimbursement rate and a recurrent mechanism to measure costs and justify future rate increases. The co-chairmen of the Congressional Air Medical Caucus on February 10 introduced legislation, H.R. 822, that would amend title XVIII of the Social Security Act to require reporting of certain data by providers and suppliers of air ambulance services for purposes of reforming reimbursements for such services under the Medicare program. While this data is being accumulated, air medical providers would see a 20-percent increase in the Medicare air medical transport base rate the first year after enactment, with subsequent 5-percent increases for the next three years.

Patients covered by Medicare and Medicaid account for approximately 56 percent of all medical transport flights, and air medical providers have long maintained that reimbursements from these programs do not cover actual costs, forcing them to charge more for those who self-pay or those with private insurance, who represent 11 percent and one-third of all patients, respectively. For those with private insurance, insurers cover the costs approximately 80 percent of the time. 

The legislation introduced by caucus co-chairmen Reps. Pete Sessions (R-Texas) and Gregory Meeks (D-N.Y.), along with Todd Young (R-Ind.) and Bill Johnson (R-Ohio), would require the Department of Health and Human Services to create and implement a system for air medical Medicare providers to report their cost on specific cost drivers that represent the basic operational costs at an average air medical base. The Government Accountability Office (GAO) would be tasked with analyzing this cost data and issuing a report to Congress to provide realistic guidance for future reimbursement rate adjustments. Additionally, the bill calls for the Secretary of HHS and the GAO to issue a report, updated annually, on certain industry clinical quality measures taken from the Air Medical Physicians Association 2013 “Must Have” Consensus Metrics.

The bill identifies air medical cost drivers as maintenance, medical supplies, fuel, employee expenses, recurring training (aviation, maintenance, communication and clinical), rent and utilities, communications, travel, insurance, marketing, supplies, overhead, support, aircraft ownership expense, safety-enhancement capital costs and safety-enhancement recurring costs.