AAMS Successful in Protecting Air Medical Services in FAA Bill

Early on Saturday morning, the House Transportation and Infrastructure Committee filed the “FAA Reauthorization Act of 2018” (H.R. 302). The leadership of the Transportation and Infrastructure Committee and the Senate Commerce Committee agreed to the text of this legislation after weeks of negotiations.

The House-passed version of FAA reauthorization legislation (H.R. 4) included a provision that would have exempted air medical services from the Airline Deregulation Act (ADA), allowing each state to establish its own separate regulatory regime over air medical transportation. This change would have opened the door to a patchwork of conflicting rules governing air medical services and rates.

AAMS successfully advocated for House and Senate negotiators to reject any change to the application of the ADA to air medical services. This effort could not have succeeded without the support and engagement of AAMS’ members throughout the process.

Congressional negotiators did agree to the following provisions intended to address air medical billing and transparency issues:

  • Section 418 of H.R. 302 will establish an Advisory Committee on Air Ambulance and Patient Billing. The Committee will be organized by the Secretary of Transportation and led by her designee, and will include one representative each from: the Department of Health and Human Services; “each relevant Federal agency, as determined by the Secretary of Transportation”; “State insurance regulators”; “Health insurance providers”; “Patient advocacy groups”; “Consumer advocacy groups”; and a “Physician specializing in emergency trauma, cardiac, or stroke”. The Advisory Committee is tasked with identifying “options to improve the disclosure of charges and fees for air medical services, better inform consumers of insurance options for such services, and protect consumers from balance billing.” It must issue its report within six months of its first meeting. The legislation directs the Secretary to consider the Committee’s recommendations, and issue “regulations or guidance as necessary”: (1) “to require air ambulance providers to regularly report data to the Department of Transportation;” (2) “to increase transparency related to Department of Transportation actions related to consumer complaints; and” (3) “to provide other consumer protections for customers of air ambulance providers.”
  • Section 419 amends the existing law governing the Department of Transportation’s (DOT) collection of aviation consumer complaints to clarify its applicability to air medical operations. This section requires air ambulance operators to provide DOT’s consumer complaint hotline telephone number and website, as well as the contact information for the Department’s Aviation Consumer Advocate.
  • Section 420 directs the Secretary of Transportation to report to Congress on its oversight of air ambulance providers within six months of completion of the report by the Advisory Committee on Air Ambulance and Patient Billing.

Other provisions of the bill affecting air ambulance services include:

  • Section 314 directs the FAA Administrator to review existing heliport and helipad data, and, if needed, “develop…a new database of heliports and helipads used by helicopters providing air ambulance services.” It also updates and clarifies the FAA air medical data collection requirements established in the 2012 “FAA Modernization and Improvement Act”.
  • Section 315 requires the FAA Administrator to “convene an aviation rulemaking committee to review, and develop findings and recommendations regarding, pilot rest and duty rules under part 135…”
  • Section 317 includes the helicopter Crash Resistant Fuel System requirements included in the House-passed FAA bill. 

The House could debate the bill under the expedited process known as “Suspension of the Rules” as soon as Wednesday. Under this process, the bill cannot be amended, and debate is limited. Passage under Suspension of the Rules requires a two-thirds vote. The Senate is expected to take up the bill soon after House passage.

Overview

Last week, the Senate passed: the “Patient Right to Know Drug Prices Act” (S. 2554); the “Opioid Crisis Response Act of 2018” (H.R. 6); and the conference report accompanying “the Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019” (H.R. 6157).

The House was in recess last week, but reconvened this week with an agenda that includes: the “American Innovation Act of 2018” (H.R. 6756); the “Family Savings Act” (H.R. 6757); the “Protecting Family and Small Business Tax Cuts Act of 2018” (H.R. 6760); the conference report accompanying “the Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019” (H.R. 6157); and the “FAA Reauthorization Act of 2018” (H.R. 302).

The Senate reconvened on Monday and voted on two Executive Branch nominations. It could vote on the “FAA Reauthorization Act of 2018” once the House approves the legislation.

Member Reminder

AAMS fully supports the “Ensuring Access to Air Ambulance Services Act” (H.R. 3378 and S. 2121), bipartisan legislation that would address the shortfall in Medicare reimbursements for air medical services. AAMS encourages members to contact their Senators and Members of Congress to ask them to cosponsor the legislation.

The bills would reform the Medicare fee schedule for air ambulance services, starting with a cost reporting and analysis program conducted by the Centers for Medicare and Medicaid Services (CMS), followed by: rebasing of air medical reimbursements; and implementation of a Value-Based Purchasing (VBP) Program. The bill would enhance transparency by establishing cost and quality reporting requirements, as well as solve for a growing gap between Medicare payments and costs.

Representatives Jackie Walorski (R-IN), Suzan DelBene (D-WA), Bill Johnson (R-OH), Raul Ruiz (D-CA), and Pete Sessions (R-TX) introduced H.R. 3378.

The following Members of Congress have cosponsored the bill since its introduction, bringing the total number of cosponsors to 45:

  • Tom Cole (R-OK);
  • Jason Smith (R-MO);
  • Blaine Luetkemeyer (R-MO);
  • David Loebsack (D-IA);
  • Mike Kelly (R-PA);
  • Kenny Marchant (R-TX);
  • Terri Sewell (D-AL);
  • Ed Perlmutter (D-CO);
  • Julia Brownley (D-CA);
  • Jacky Rosen (D-NV);
  • Ami Bera (D-CA);
  • Scott Tipton (R-CO);
  • Mike Coffman (R-CO);
  • Luke Messer (R-IN);
  • Filemon Vela (D-TX);
  • Tom O’Halleran (D-AZ);
  • Anna Eshoo (D-CA);
  • Martha McSally (R-AZ);
  • Jared Polis (D-CO);
  • Roger Williams (R-TX);
  • Doug LaMalfa (R-CA);
  • David Young (R-IA);
  • Tom Marino (R-PA);
  • Rodney Davis (R-IL);
  • Tom Reed (R-NY);
  • Elise Stefanik (R-NY);
  • Mark Takano (D-CA);
  • Vincente Gonzalez (D-TX);
  • Dina Titus (D-NV);
  • Diane Black (R-TN);
  • Jim Banks (R-IN);
  • Kyrsten Sinema (D-AZ);
  • John Faso (R-NY);
  • Pete Aguilar (D-CA);
  • Steven Palazzo (R-MS);
  • John Garamendi (D-CA);
  • Sam Graves (R-MO);
  • Steve King (R-IA);
  • Ralph Abraham (R-LA);
  • Ruben Kihuen (D-NV); and
  • Trey Hollingsworth (R-IN).

Senators Dean Heller (R-NV), Michael Bennet (D-CO), and Cory Gardner (R-CO), introduced the Senate version of the bill. Senators Catherine Cortez Masto (D-NV), Tim Scott (R-SC), Shelley Moore Capito (R-WV), Todd Young (R-IN), and Doug Jones (D-AL) are also cosponsors.

Additional information on this legislation, as well as on how to contact your Member of Congress and Senators: