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Air Ambulance Letter to Senate

August 2, 2018

SPBA collaborates with other industry groups in Washington DC and is invited to sign on to letters supporting various legislative initiatives from time to time.  Below is one such letter on the issue of Air Ambulance regulation.  The SPBA Board has decided to sign on to this letter.

There is a short time window for responding and taking advantage of this opportunity. The vehicle for an amendment on Air Ambulance Regulation is the Federal Aviation Administration (FAA) Reauthorization bill. The FAA’s current authorization bill expires October 1, and the Senate is expected to take up a new reauthorization shortly after they return from recess on August 15.

If you would like to alert your Senators who are currently serving on the Senate Committee on Commerce, Science, and Transportation, which has jurisdiction over this bill, you should do so as soon as possible. The letter SPBA joined is included below for your reference. Please feel free to use this letter as a guide, as well as personalize it your own experiences or expertise with this issue.

Here is a list of Committee members:    



Thune, John (SD), Chairman 
Wicker, Roger F. (MS)
Blunt, Roy (MO)
Cruz, Ted (TX)
Fischer, Deb (NE)
Moran, Jerry (KS)
Sullivan, Dan (AK)
Heller, Dean (NV)
Inhofe, James M. (OK)
Lee, Mike (UT)
Johnson, Ron (WI)
Capito, Shelley Moore (WV)
Gardner, Cory (CO)
Young, Todd (IN)

Nelson, Bill (FL), Ranking Member 
Cantwell, Maria (WA)
Klobuchar, Amy (MN)
Blumenthal, Richard (CT)
Schatz, Brian (HI)
Markey, Edward J. (MA)
Udall, Tom (NM)
Peters, Gary C. (MI)
Baldwin, Tammy (WI)
Duckworth, Tammy (IL)
Hassan, Margaret Wood (NH)
Cortez Masto, Catherine (NV)
Tester, Jon (MT)


August 3, 2018

Senator John Thune, Chairman
Committee on Commerce, Science, and Transportation United States Senate
512 Dirksen Office Building
Washington, D.C. 20510

Senator Bill Nelson, Ranking Member
Committee on Commerce, Science, and Transportation United States Senate
512 Dirksen Office Building
Washington, DC 20510

Dear Chairman Thune and Ranking Member Nelson:

As your committee works to produce a comprehensive FAA reauthorization bill, urgent attention is needed to reform the regulation of the air ambulance system in our nation. Without reform, America’s families and health care providers face an increasing and often conflicting set of rules and regulations that fail to provide any semblance of financial certainty when life-saving air ambulance services are employed.

With increasing frequency, patients are faced with tens of thousands of dollars in medical bills from air ambulance services after a traumatic injury—of which health insurance sometimes only covers a fraction of the costs. Rural areas of the country are especially hurt by the soaring costs of air ambulance services, as many times ground transportation options are too slow or unfeasible for critically injured patients. Additionally, this issue has adversely impacted workers compensation insurance claims in states, as many times there are questions as to which laws ultimately apply to air ambulance rates in a workers compensation situation.

The Airline Deregulation Act of 1978 (ADA), originally passed with the intent of encouraging competition in the airline industry, prohibits states from regulating the prices air carriers charge, including air ambulances. Despite many states’ attempts to pass laws to provide reasonable guidelines to regulate the costs of air ambulance services, they have been preempted by the ADA. The lack of oversight has allowed the prices of these services to increase dramatically, along with increased utilization rates. The Association of Air Medical Services estimates that more than 550,000 patients in the U.S. require air ambulances each year. Allowing states greater oversight in this area would be consistent with how other health care providers and insurance matters are currently regulated.

During the FAA extension debate in 2016, Senators Tester of Montana and Hoeven of North Dakota offered an amendment allowing states to decide if they want to create rules governing air ambulance rates and services.

The text of the amendment stated:

“Notwithstanding any other provision of law or regulation, including section 41713 of title 49, United States Code, a State may enact or enforce a law, regulation, or other provision having the force and effect of law that regulates the price or service of an air carrier that provides air ambulance service in that State.”

We urge you to include a similar provision in the current FAA reauthorization bill under consideration to allow states to provide greater clarity and certainty to this increasingly complex and expensive health care service. With the number of Americans left with soaring air ambulance costs on the rise and the uncertainty this creates for workers compensation cases, now is the time to grant states the authority to oversee this critical service to so many Americas.

Thank you for your consideration in addressing this important issue as you finish your work on the reauthorization bill, and we look forward to working with you on addressing the needs of your constituents.