04/28/21
Jon L. Gelman
The US Supreme Court (SCOTUS) will not review the pre-emption issue involving air ambulance billing charges. A
Petition for Certiorarithat was denied was filed by PHI Air Medical, LLC following the
denial of the Texas Supreme Court to honor the full air ambulance billing changes in a workers compensation claim.
Medical benefits are a significant factor in the overall costs of most state workers compensation programs. The ability to contain those costs is at the very heart of the viability of most workers compensation systems. Federal preemption of state medical fee schedules and regulations is a prevailing challenge to the patchwork of non-uniform state benefit programs.
U.S. Supreme Court Hands Texas Insurers a Win in Air Ambulance Billing Battle April 28, 2021
A 2020 decision by the Supreme Court of Texas that limits workers’ compensation air ambulance payments to what is “fair and reasonable,” has been allowed to stand by the U.S. Supreme Court, according to workers’ compensation insurer Texas Mutual.
The company said there “has been a drastic increase in air ambulance prices since 2012 when large private equity companies that had acquired air ambulance operations began increasing their billed charges dramatically. At the same time, these companies argued in courts in Texas and around the nation that a federal law requires state-regulated workers’ compensation insurers to pay any price they demand.”