Over the past few weeks, multiple people reached out to the 13 HELP Team saying they were charged for ambulance services they never received. The bills came from a company called American Medical Response, or AMR, which is under federal investigation for possible fraud and other violations.
AMR says it has settled a federal lawsuit and is working with state attorneys to settle complaints from other consumers. But those who were hit with the charges say the company isn’t taking any responsibility for what happened to them.
Across the country, 14,000 ambulance services operate, mostly run by local governments, volunteer fire departments and rescue squads, or for-profit companies that contract with towns, cities and hospitals. The federal government sets reimbursement rates for medicare and Medicaid, which helps keep prices low. But it doesn’t regulate fees for private insurance or Medicare Advantage plans, which leads to a system where the cost of a ride can vary widely from town to town and company to company.
In recent months, outrage over surprise medical bills prompted 21 states to pass laws (PDF) protecting consumers from them in some situations. But those laws largely ignore ground ambulance rides, which are one of the most common sources of out-of-network charges and can leave patients with hundreds or even thousands of dollars in bills.
The problem is complex. Ambulance providers are struggling to make ends meet because demand for non-emergency transports dropped during the pandemic as people feared being exposed to COVID-19 and opted to stay home. Insurance companies have tried to protect their customers by negotiating rates with ambulance services and forcing them to join their networks, but those negotiations often aren’t effective, according to the nonprofit America’s Health Insurance Plans.
Consumer Reports has collected hundreds of stories from consumers who were hit with unexpected ambulance bills. Almost all of the incidents involved out-of-network charges, and many were for non-emergency transportation to hospitals. Some of the bills were for more than $10,000.
AMR says the company is cooperating with federal and state authorities investigating its billing practices and will be implementing new policies to prevent any future problems. Those changes include separating its Advanced Life Support services, which involve paramedics on the scene and in the ambulance, from its Basic Life Support services, which typically only involve transporting a patient to the hospital.
The company also is reducing its base rates and adding a surcharge to cover the cost of equipment and other expenses. AMR says it’s trying to be transparent and honest with its customers. “We know that our consumers expect a higher level of service from us than they do from their own health insurance companies, which often charge them much more per month for fewer benefits,” the company said in a statement. “That’s why we work hard to offer the best value and a great experience to our customers.” The changes will be effective May 1. But consumers who are concerned about their bills should contact their insurer and ask about the provider’s network. American Medical Response Billing