Effects Of Air Ambulance Changes On Services Are Unclear
October 2, 2010 -
Changes in the air ambulance industry's size and structure have led to
differences of opinion about the implications for air ambulance use,
safety, and services. Some industry stakeholders believe that greater
state regulation would be good for consumers.
While states can regulate the medical aspects of air ambulances, the Airline Deregulation Act (ADA) preempts states from economic regulation, i.e., regulating rates, routes, and services of air ambulances. Other stakeholders view the industry changes as having been beneficial to consumers and see no need for a regulatory change.
Government Accounting Office (GAO) was asked to review the
From 1999 through
2008, the number of patients transported by helicopter air ambulance
increased from just over 200,000 to over 270,000, or by about 35
percent, and the number of dedicated air ambulance helicopters increased
from 360 to 677, or by about 88 percent.
the implications of these changes vary. Supporters of the existing
regulatory framework say that the growth in the number of helicopters
provides, among other things, flexibility to perform aircraft
maintenance on some helicopters while keeping others available to
respond as needed.
The GAO data shows
court cases and advisory opinions from the Department of Transportation
(DOT) have helped clarify the relationship between federal and state
oversight and regulation of the air ambulance industry, but DOT has
acknowledged a continuing lack of clarity in some areas.
However, when both
economic and medical or safety and medical issues are involved,
questions about jurisdiction may arise. To resolve such questions,
states have sought DOT's opinion and, in response, DOT has issued eight
opinion letters since 1986.
continue to seek DOT's opinion on a case-by-case basis, as further
questions surface. Additionally, states can also contract directly with
air ambulance providers, which would allow states to control specific
services as the customer.
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