About a year and a half ago, James W. Ferrell went to the emergency room of the Bradley County Medical Center in Warren complaining of chest pains. Shortly thereafter, he was placed into an Air Evac Lifeline helicopter and transported 41 miles to Jefferson Regional Medical Center in Pine Bluff. A couple of months later, Ferrell, of Wilmar, received a bill from Air Evac EMS, Inc. for $30,083.

That bill prompted a class action lawsuit last week against Air Evac EMS, Inc., the first filed in Arkansas against an air ambulance service.

Ferrell says he was not given a choice of the type of ambulance transport from BCMC to JRMC, was not informed that the cost would be more than $30,000, that his insurance through Arkansas Blue Cross would pay only $1,000 of the charges, or that he would be billed for the balance.

Through his attorney, Cliff Gibson of the Gibson and Keith law firm in Monticello, Ferrell filed a class action lawsuit in Drew County Circuit Court against Air Evac EMS, Inc., on behalf of similarly situated plaintiffs in Arkansas.

In his lawsuit, Ferrell accuses Air Evac EMS, Inc. of “price gouging” and uses Air Evac’s own statements to support his accusation.

Last summer, Air Evac EMS, Inc. filed a lawsuit against Arkansas Blue Cross & Blue Shield in U.S. District Court for what it claims is a pattern of underpayment of patient claims for air ambulance service. In that lawsuit, Air Evac said the Medicare reimbursement rate in Arkansas is a flat rate of $4,877 plus $34 per mile.

Based on Air Evac’s statements as to the Medicare reimbursement rates for its service, Medicare would have paid $6,271.55 for the air ambulance transport of Ferrell for the 41-mile trip from BCMC to JRMC. The math is as follows: $4,876.73 plus $1,394.84 (34.02 per mile times 41 miles) for a total of $6,271.55. The $30,083.26 bill Mr. Ferrell received is nearly 500 percent higher than what Medicare would pay Air Evac for the same service.

Attempts to rein in the costs of air ambulance services have been met with lawsuits arguing that air ambulances fall under the 1978 Airline Deregulation Act, which prevents states from interfering with fares, routes, and services.

“… (Air Evac) has successfully taken the legal position in the Courts of our Country that there are no legally enforceable limits whatsoever on what it can charge a patient for air ambulance service, and that the patient has no right or ability to challenge the amount charged — today it may be $30,000 for a 15 minute helicopter ride — tomorrow it could be $500,000 or even a million dollars,” Ferrell alleges in his class action lawsuit against Air Evac.

Ferrell, in his lawsuit, has taken the position that since Air Evac does not tell the patient what it will charge for the service and that the patient’s insurance will not cover the cost, there is no contract. “Where there is no agreement or contract regarding a mechanism for objectively determining the price to be charged and paid for the transport, there can be no valid contract upon which (Air Evac) might hold patients liable for the transport,” Ferrell’s lawsuit reads.

Nevertheless, Air Evac continues to bill patients for its “outrageous charges” and sues patients to collect charges that collectively run into tens of millions of dollars, according to the lawsuit. Air Evac says Arkansas Blue Cross and Blue Shield alone owes more than $10 million in underpayments for air ambulance service for Arkansas insureds.

While this is the first lawsuit filed in Arkansas against an air ambulance service provider, numerous lawsuits making the same allegations against helicopter medevac companies have been filed across the country and the numbers are increasing.

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