On December 27, 2020, the No Surprises Act was signed into law. That Act introduced sweeping changes to how group health plans are allowed to handle payment of non-network providers and balance billing. However, it also required the Departments of Labor, Health and Human Services, and the Treasury to create reporting rules for air ambulance claims. The Act required plans to report the following on air ambulance claims:
- Whether the service were furnished on an emergency basis;
- Whether the provider is hospital-owned, municipality-owned, hospital-independent (hybrid), independent, or tribally operated program;
- Where the transport originated (i.e., rural or urban);
- The type of aircraft used (e.g., rotor vs. fixed wing transports);
- Whether the plan or insurance carrier has a contract or agreement with the provider; and
- Any other information requested by the Secretaries.
On September 16, 2021, the Departments issued proposed regulations that required calendar year 2022 data to be submitted by March 31, 2023 and 2023 data to be submitted by March 31, 2024. Under the proposed regulations, plans would be required to report the above information on all air ambulance services furnished and claim payments made during the calendar year (even if the payments related to services provided in a different year). The rules indicated that there would be further guidance as to how the information would be submitted. However, the regulations have not been finalized so it is unclear at this time when, and even how, plans will submit this data.
This delay is welcome news for plans and issuers as they work to submit the medical and prescription data required under the No Surprises Act. However, this delay is probably short-lived and plans and carrier should prepare for another round of claims data reporting.