A topic in the air ambulance world that’s being discussed among air medical crews in all 50 states is the new bi-partisan bill, S. 1407, that’s – rather miraculously – made its way to the floors of the embattled U.S. Congress. The bill, introduced by Senator Maria Cantwell of Washington and Senator Olympia J. Snowe of Maine aspires for a new level of safety regulations for air ambulances, based on the higher standards that are already in place in states like Washington and Maine.
S. 1407, the Air Ambulance Medicare Accreditation and Accountability Act, would tie Medicare reimbursement to the new safety standards, restructuring the current reimbursement system to reflect air ambulance services’ investments in safety. Consequently, this would provide even more motivation for air medical services all over the United States to increase safety levels above and beyond their already high standing.
“Air medical providers that fly safer aircraft and provide the highest quality care are struggling to survive on the current fee schedule,” said Senator Snowe. “At the same time, air medical providers that skimp on those same quality and safety investments are making considerable profits at the expense of patients and taxpayers.”
Senator Cantwell believes that extending the same high safety standards that air ambulance services in her state are required to abide by to all U.S. states will ensure safer inter-state transport of patients. She also believes that revising Medicare reimbursements to reflect operators’ investments in safety will result in more incentive for the operators to make those investments.
It seems incredible, but every single day, there are about 400,000 patients and transplant organs transported by helicopter in the United States. Meanwhile, some regions of the country are in debate over what some see as an inappropriate over-utilization of air ambulance services for cases where it is not an absolute necessity. The Air Ambulance Medicare Accreditation and Accountability Act should level out some of the wide variance from state to state in terms of air ambulance capability, service/care quality, and overall level of safety.
Senator Snowe pointed out that “one size does not fit all when it comes to lifesaving services provided to Medicare beneficiaries.” She recalled the recent case in which the lack of air conditioning in a medical helicopter transport may have contributed to the death of a heat stroke victim. She believes the new reimbursement schedule will result in higher quality and value in the health care system, and stronger performers in air medical transport overall.
Between the five years from 2003 to 2008, 85 air ambulance accidents resulted in 77 fatalities nationwide. 2008 had the most fatalities, with 29 in total. In 2010, there were less – 12 crashes with 7 fatalities – but still, we can all agree, far too many.
Conversely, the last fatal air ambulance crash to occur in Washington state, where air ambulance safety requirements are held to a higher standard, was in September 2006. That accident occurred when an Airlift Northwest helicopter crashed into Puget Sound, resulting in the tragic deaths of a pilot and two nurses.
In 2009, the NTSB took hold of the issue and provided a list of 21 official recommendations based on their analysis of accidents and the underlying economics of air ambulance services. One of the NTSB’s recommendations was to establish Medicare accreditation of those air ambulance services, similar to the accreditation other health care providers are required to achieve.
Part of the Air Ambulance Medicare Accreditation and Accountability Act allows for the Secretary of Health and Human Services to set safety standards for accredited air ambulance services within two years of the bill’s enactment.
There will also be certain set instances in which Medicare reimbursement will not be provided to the air ambulance service at all under the new bill. These include events such as patient death or serious disability due to the failure or crash of the medical transport vehicle, as well as an air ambulance service responding to an event without first getting a formal request to do so.
Despite the federal government’s call for higher air ambulance service safety standards, air ambulances will continue to get their licensing from the state in which they are based.
As an air ambulance service crewmember, pilot, operator – or just an air ambulance enthusiast – how do you feel about S. 1407, the Air Ambulance Medicare Accreditation and Accountability Act? Is it needed now more than ever, or is it unnecessary legislation? Let us know your opinion on this hot-button topic below.