American Medical Response Billing
Almost half of all ambulance services are run by local governments, often via police or fire departments and partly funded by taxpayers. The rest are for-profit or not-for-profit companies that towns, cities, and hospitals contract with for ambulance services. Some, like the Hartford-based company AMR, are accused of overbilling Medicare and other payers. “Waste and fraud are rampant,” says an official with the federal Centers for Medicare & Medicaid Services.
The company is facing a federal investigation for allegedly overcharging Medicaid and other public payers by using false and misleading claims. For example, AMR billed Medicare for providing advanced life support services when the patient was only transported to the hospital from their home. This is a violation of both state and federal laws.
It is also illegal to charge patients for a service that is not covered by their insurance. Yet this happens frequently with ground ambulances, which aren’t subject to the same consumer protections as air ambulances. “Surprise billing is a huge problem with ground ambulances,” says Betsy Imholz, special projects director at Consumers Union, the nonprofit policy and advocacy group that publishes the product-testing and rating publication Consumer Reports. “A lot of people get these bills, and they’re a lot bigger than a visit to the ER.”
Many ground ambulance services don’t participate in an insurance network, which means they can legally charge patients the full amount—or sometimes more—that their insurer won’t cover. This can happen even when the transport starts at a hospital that is in-network. “It’s a huge loophole,” says Imholz. “That’s why we’re calling on Congress to close it.”
In fact, a bipartisan proposal introduced in the House and Senate last year would have put the brakes on surprise ambulance billing by requiring all EMS providers to accept in-network payment rates from private insurers as well as Medicare. The measure failed to advance.
Most states don’t have laws limiting the amounts that ambulance companies can charge, and most of those that do aren’t enforced. So it’s up to patients and their advocates to make sure they understand their rights and how to fight back against a surprise bill.
CR has collected hundreds of stories about unexpected ambulance charges and is working to help consumers get their money back. The easiest way to do this is by using doxo, the secure all-in-one app that organizes all your provider accounts in one place and enables reliable payment delivery to thousands of billers. It’s free to use with a linked bank account. For other payments, there is a small fee. Learn more. American Medical Response Billing