ST. LOUIS – Contact 2 has investigated insurance denials on air ambulance claims for several years. On Thursday, U.S. Senator Claire McCaskill will introduce legislation she hopes will bring greater transparency and consumer protections to the air ambulance industry, and allow states to better regulate medical costs associated with air ambulance services.
McCaskill’s announcement comes days after Contact 2’s Mike Colombo reported on a new case involving a St.Louis area family on the hook for nearly $35,000. Anthem Blue Cross Blue Shield denied their claim for an air ambulance transport from Missouri Baptist Hospital to St.Louis Children’s Hospital for their newborn premature baby.
Our news partners at the St.Louis Post-Dispatch have also reported extensively on the issue.
“They don’t just call helicopters for no reason. It’s not like these pilots are just out on joy rides. It’s because people are in critical situations that they need it,” said Julie Zapor, the child’s mother.
After interviewing the Zapor’s Colombo contacted Anthem and requested it take another look at the Zapor’s case.
“Since you got involved, the insurance company has decided to do the right thing and they have paid the claim in full,” said Zapor.
In a statement, an Anthem spokesman told Fox 2’s Mike Colombo the company reviewed the Zapor’s case, and based on additional information covered the claim in full.
“Once we got the news that it was covered thanks to your work, it was like the biggest burden was lifted off our shoulders,” Zapor said.
While Anthem’s change of heart is a huge victory for the Zapor’s and the Contact 2 team, it’s just one case. There are many other family’s fighting appeals.
According to a release from Sen. McCaskill’s office, the Air Ambulance Consumer Protection Act would clarify that states are not prohibited by the Airline Deregulation Act of 1978 from regulating the medical costs associated with air ambulance service.
Additionally, McCaskill’s legislation would provide consumers with a complaint hotline that commercial aviation customers have, as well as establish an advisory committee to produce recommendations for the industry, including greater transparency in billing practices, new consumer protections, and clear guidance for State insurance commissioners on how to dispute unfair or deceptive industry practices on behalf of consumers.
“You never plan to be in a situation that requires an air ambulance, but in an emergency, a family doesn’t have time to read the fine print and try to figure out which company is in-network, or if their insurance will actually cover the costs,” McCaskill said. “Air ambulances, while they provide a lifesaving service, are currently operating in a grey area between healthcare and aviation, and have managed to not be held accountable by anyone—and it’s time for that to change. This bill will allow states to properly regulate air ambulance costs, which have skyrocketed in the last decade, and give consumers much-needed protections.”
In April 2018, McCaskill sent letters to nine different air ambulance providers and insurance companies asking for documents and information on their industry and practices.
Fox 2/KPLR 11 is going to continue to follow this issue and share developments along the way.