My daughter broke her collarbone goofing around on the field at school last spring. The principal called an ambulance, which arrived before I did. When I saw that my daughter was mobile and the EMTs said she wouldn’t sustain further injury, I told the ambulance to leave and drove my daughter to the hospital myself. Bad parenting? Maybe. (My kids have said that before). But it’s also because I know the dirty truth about ground ambulances.
One of my favorite things about my job is that even though I’m middle aged, I learn something new almost every day. And since I work for The Public Interest Network, most of what I learn is in the public interest — and in mine.
For the past few years, I have worked with PIRG’s Senior Director of Health Care Campaigns Patricia Kelmar to raise public awareness of the problems of “surprise billing.” When an insured patient sees an out-of-network medical provider and doesn’t know up front how much it will cost, the insurance company may pay some of it regardless, but the remainder (or “balance bill”) can be quite an unwelcome surprise.
The No Surprises Act, which took effect nationwide on Jan. 1, 2022, limits surprise bills in out-of-network hospitals and clinics. It even curbs your out-of-pocket costs if an out-of-network air ambulance has to pick you up in a remote location and fly you to a trauma center. Yet, ironically, out-of-network ground ambulances didn’t make the cut when Congress passed the law. So, if you pass out from the heat and a Good Samaritan calls for an ambulance to pick you up — or if an ambulance drives your daughter 5 miles from her school to the hospital — you could be on the hook for hundreds of dollars or even four figures.
Last spring, with that in mind, and the EMTs saying it would do no harm, I had no qualms about forgoing the ambulance for the ride to the hospital. But most people don’t have my knowledge of the ambulance ecosystem. While the No Surprises Act has prevented about a million out-of-network hospital and air ambulance surprise bills for insured patients every month, those who need to use a ground ambulance have a 50% chance of getting a huge out-of-network bill, added adding insult to injury when the bill arrives weeks later.
It shouldn’t be this way. If someone is injured or ill enough to call for — or have someone else call for — an ambulance, they shouldn’t have to “shop around” for the closest in-network option.
I’m not sure why Congress left this loophole in the No Surprises Act, but it wasn’t an accident. Recognizing that, the act mandated the creation of an Advisory Committee on Ground Ambulance and Patient Billing. This committee, which features Patricia Kelmar as a consumer advocate, is charged with conducting appropriate analysis and issuing recommendations to protect consumers from ambulance surprise bills. The committee will meet at least twice during 2023, and its final report is due no later than 180 days after the initial meeting.
Until then, I’ll keep hoping I don’t have to call for an ambulance — and that if I do, whoever is sick or hurt is well enough to avoid getting taken for a ride.
P.S. If you’ve received an ambulance surprise bill, share your story with Patricia. Your story could influence the outcome of the committee meetings on how best to protect consumers from these bills.
Director of Media Relations, The Public Interest Network
Mark leads The Public Interest Network’s national communications and media relations campaigns. Before joining The Public Interest Network, Mark worked at CNN for nearly 20 years, and taught writing classes for six years through the Turner Professional Development Center. Mark was the recipient of an Emmy Award, two Peabody Awards and a DuPont Award. Mark currently lives near Denver, Colo., with his wife and three children. He's also a music fanatic who's been lucky enough to interview many of his favorite artists.