Two years ago, the Madison County commissioners purchased a county-wide air ambulance membership through what is now AirMedCare Network. Due to legislation passed in the 2017 session, AirMedCare Network has pulled its membership program from the state of Montana. But what does this mean for Madison County residents?
House Bill 73
House Bill 73, which was signed into law in April, classifies air ambulance memberships as insurance, meaning membership programs must be regulated by the state insurance commission and operate under a license.
“We can’t meet those requirements right now,” said Holly Anderson, on behalf of AirMedCare Network during the Madison County commissioner’s regular meeting on June 27. “We decided to take a step back until we can.”
Under the new legislation, private air ambulance services are no longer exempt from insurance regulations, meaning they have to operate by the newly established fees, licensing, trade filing and recordkeeping requirements.
According to Anderson, AirMedCare Network operates their membership program as a “prepaid discount program” meaning they have no varying levels of coverage and no premiums. Anderson said the company feels they do not fit under the insurance umbrella.
“That’s one of the reasons we decided to stop, because it’s not an insurance program and it doesn’t seem appropriate at this time,” Anderson said.
What it means for Madison County
The 2015 Madison County contract was with REACH Air Medical, which works in conjunction with AirMedCare Network, to cover all county residents should they receive air assistance in either Madison or Gallatin counties. Through the contract with the county, residents then had the option to upgrade to the national membership program at a discounted price.
The contract signed with the county was a municipal site plan, meaning for any insured Madison County resident transferred from Madison County or Gallatin County to a care facility, there would be no out of pocket expense. If you were not insured, you would be billed at the Medicare rate, or if you had purchased the membership upgrade, you would be covered.
The county renewed their yearly contract in June 2016, and it expired on July 5, 2017. Because of the new legislation and AirMedCare Network’s decision to pull their membership out of Montana, the county cannot renew their contract.
“As a Madison County commissioner, I’m disappointed that (the county) can no longer offer memberships,” said Jim Hart, commission chair. “It was one of the few things we could give back to our constituents.”
Hart said he was unsure of the county’s next steps.
“We wait and see what the opportunities are and ask questions with (Montana Association of Counties),” he said.
While AirMedCare Network and REACH Air Medical are owned by the same company, the two are separate, individual companies, according to Anderson.
“REACH is the operations group,” she said. “They operate the aircraft and medical group that staffs it.”
The new legislation will not affect REACH Air Medical and they will continue to operate air services in the state out of their bases in Helena and Bozeman. However, while HB 73 does not affect REACH Air Medical, they are affected by another new bill from the 2017 legislative session, Senate Bill 44.
SB 44 forces insurance companies and emergency providers to find a compromise about a patient’s coverage, or lack thereof, or settle in court in an effort to “hold patients harmless,” the catch being if patients are insured by a Montana insurance company.
For example, if you are flown by an air ambulance service in Montana and are insured through a Montana insurance company, you would only be responsible for your copays and deductibles. However, if you are a resident of Montana but are flown out of another state or your insurance company is based in another state, you may not be “held harmless” via the new legislation.
Anderson said the future of AirMedCare Network and a Montana membership program is not off the table forever.
“At whatever point we meet the regulations or the regulations change, we absolutely want to come back to the state,” she said. “That’s why we’re being so careful – everything we’re doing is with the intent that if we’re able to come and do business, it’s in good standing.”
“I think in time, with MACOs assistance, we can get some of this streamlined and end up with a better product,” added Hart.