A recent case in federal appeals court backed an air ambulance company in a dispute about whether the amount billed for services should be limited by Florida’s no-fault auto insurance law. This case comes from a child being rushed to a hospital via helicopter after a serious car accident, and whether or not it was appropriate for the company to bill the child’s father above and beyond the limits of the state’s no-fault system.
The ruling, in short, upheld a decision in lower courts that stated federal airline deregulation rules bar states from restricting airline carrier prices—and air ambulances are considered airline carriers under the law.
Personal injury insurance wasn’t enough
In March 2013, Lemar Bailey was involved in a car accident where he was ejected from the vehicle. An air ambulance transported him to a hospital in West Palm Beach where he later died from his injuries. The company, Air Methods Corp., billed $27,975 for its services. The child’s father had personal injury insurance (PIP) on his auto insurance, which helps pay for medical expenses after an accident. The PIP paid out $6,911, and his health insurance paid another $3,681, leaving a balance of almost $17,400.
Mr. Bailey did not pay this balance but rather filed a lawsuit against Air Methods, alleging the company was trying to improperly collect the funds via a practice called balance billing. Bailey’s attorneys stated in a brief, “The allowed reimbursement amount for emergency transport service is set forth with particularity in the PIP statute. The PIP statute authorizes insurers to limit payment in accordance with the fee schedule set forth therein. Once a PIP insurer limits payment for such services in accordance with the fee schedule, an emergency transportation provider is prohibited from billing or collecting from the patient any amounts other than the PIP coinsurance amount or any amount not paid due to exhaustion of PIP benefits.”
The Airline Deregulation Act
However, the courts disagreed, citing the Airline Deregulation Act, a federal law. The appeals court, when siding with Air Methods, felt that the company is not beholden to balance billing rules. Because Florida law requires air ambulances to transport individuals with immediate medical needs, the law also gives those companies the right to a reasonable fee.
In their ruling, the judges explained that, by attempting to use the balance billing provision, Mr. Bailey was preventing Air Methods from charging a reasonable fee due to his arranged fee schedule with his auto insurance provider. Because Air Methods had no prior notice of this arrangement, and because they are considered a federal air carrier, a state-imposed restriction on billing cannot be enforced.
If you have questions about your PIP coverage, or are having trouble getting your PIP benefits paid, talk to the attorneys at Yeboah Law Group. Our goal is to protect your rights after an accident and ensure you receive all the benefits you’re entitled to. Call us at 1-800-TELL-SAM or complete our contact form to schedule a free consultation.