Missouri Democratic Sen. Claire McCaskill is probing nine air ambulance companies and insurers after a newspaper report that people are facing tens of thousands of dollars in out-of-pocket costs after emergency air transport to hospitals.
Aetna, Air Evac Lifeteam, Air Methods, Anthem, Blue Cross and Blue Shield of Kansas City, Cigna, Humana, LifeFlight Eagle and UnitedHealth Group all received letters from McCaskill requesting information on their company policies and reimbursement rate conflicts that could lead to patients and their families being on the hook for unexpected out-of-network expenses through a practice known as balance billing.
The letters follow in-depth reporting by the St. Louis Post-Dispatch that detailed the fallout from a 2016 incident in which a boy sustained a skull fracture after a fall on a campground and had to be airlifted to a St. Louis emergency room. His family has exhausted all appeals with their former insurer Anthem Blue Cross and Blue Shield over the resulting $32,000 in balance billing.
In all nine letters, McCaskill blames the failure of some insurers and air ambulance companies to agree on reimbursement terms for the financial burden on patients. She asked the companies for details about their network, the number of air ambulance flights operated in 2017, as well as summaries of all denied claims and the documentation given to patients who may want to mount a challenge or appeal to specific charges.
McCaskill has also launched inquiries into Anthem's controversial policy to deny coverage for emergency department treatment for cases that are later determined not to have been an emergency.
In February, Anthem tweaked the policy, making exceptions to the program so that it will always pay for some types of emergency visits.