Sec. 10. Reporting requirements regarding air ambulance services

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A provider of air ambulance services shall submit to the Secretary of Health and Human Services and the Secretary of Transportation— not later than the date that is 90 days after the last day of the first plan year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in subsection (d), the information described in paragraph

(2)with respect to such plan year; and not later than the date that is 90 days after the last day of the plan year immediately succeeding the plan year described in subparagraph (A), such information with respect to such immediately succeeding plan year. For purposes of paragraph (1), information described in this paragraph, with respect to a provider of air ambulance services, is each of the following: Cost data, as determined appropriate by the Secretary of Health and Human Services, in consultation with the Secretary of Transportation, for air ambulance services furnished by such provider, separated to the maximum extent possible by air transportation costs associated with furnishing such air ambulance services and costs of medical services and supplies associated with furnishing such air ambulance services. The number and location of all air ambulance bases operated by such provider. The number and type of aircraft operated by such provider. The number of air ambulance transports, disaggregated by payor mix, including group health plans, health insurance issuers, and Government payors. The number of claims of such provider that have been denied payment by a group health plan or health insurance issuer and the reasons for any such denials. The number of emergency and nonemergency air ambulance transports, disaggregated by air ambulance base and type of aircraft. Each group health plan and health insurance issuer offering health insurance coverage in the individual or group market shall submit to the Secretary of Health and Human Services— not later than the date that is 90 days after the last day of the first plan year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in subsection (d), the information described in paragraph

(2)with respect to such plan year; and not later than the date that is 90 days after the last day of the plan year immediately succeeding the plan year described in subparagraph (A), such information with respect to such immediately succeeding plan year. For purposes of paragraph (1), information described in this paragraph, with respect to a group health plan or a health insurance issuer offering health insurance coverage in the individual or group market, is each of the following: Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors: Whether such services were furnished on an emergent or nonemergent basis. Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, or independent program. Whether such services were furnished in a rural or urban area. The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services. Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such services under the plan or coverage, respectively. Such other information regarding providers of air ambulance services as the Secretary of Health and Human Services may specify. Not later than the date that is one year after the date described in subsection (b)(1)(B), the Secretary of Health and Human Services, in consultation with the Secretary of Transportation (referred to in this section as the Secretaries ), shall develop, and make publicly available (subject to paragraph (3)), a comprehensive report summarizing the information submitted under subsections

(a)and

(b)and including each of the following: The percentage of providers of air ambulance services that are part of a hospital-owned or sponsored program, municipality-sponsored program, hospital-independent partnership (hybrid) program, or independent program. An assessment of the extent of competition among providers of air ambulance services on the basis of price and services offered, and any changes in such competition over time. An assessment of the average charges for air ambulance services, amounts paid by group health plans and health insurance issuers offering health insurance coverage in the individual or group market to providers of air ambulance services for furnishing such services, and amounts paid out-of-pocket by consumers, and any changes in such amounts paid over time. An assessment of the presence of air ambulance bases in, or with the capability to serve, rural areas, and the relative growth in air ambulance bases in rural and urban areas over time. Any evidence of gaps in rural access to providers of air ambulance services. The percentage of providers of air ambulance services that have contracts with group health plans or health insurance issuers offering health insurance coverage in the individual or group market to furnish such services under such plans or coverage, respectively. An assessment of whether there are instances of unfair, deceptive, or predatory practices by providers of air ambulance services in collecting payments from patients to whom such services are furnished, such as referral of such patients to collections, lawsuits, and liens or wage garnishment actions. An assessment of whether there are instances of group health plans or health insurance issuers not providing substantial reasons for refusing to enter into contract negotiations with providers of air ambulance services. An assessment of whether there are, within the air ambulance industry, instances of unreasonable industry concentration, excessive market domination, or other conditions that would allow at least one provider of air ambulance services to unreasonably increase prices or exclude competition in air ambulance services in a given geographic region. An assessment of the frequency of patient balance billing, patient referrals to collections, lawsuits to collect balance bills, and liens or wage garnishment actions by providers of air ambulance services as part of a collections process across hospital-owned or sponsored programs, municipality-sponsored programs, hospital-independent partnership (hybrid) programs, or independent programs, providers of air ambulance services operated by public agencies (such as a State or county health department), and other independent providers of air ambulance services. An assessment of the frequency of claims appeals made by providers of air ambulance services to group health plans or health insurance issuers offering health insurance coverage in the individual or group market with respect to air ambulance services furnished to enrollees of such plans or coverage, respectively. Any other cost, quality, or other data relating to air ambulance services or the air ambulance industry, as determined necessary and appropriate by the Secretaries. The Secretaries may incorporate information from independent experts or third-party sources in developing the comprehensive report required under paragraph (1). The Secretaries may not make publicly available under this subsection any proprietary information. Not later than the date that is one year after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with the Secretary of Transportation, shall, through notice and comment rulemaking, specify the form and manner in which reports described in subsections

(a)and

(b)shall be submitted to such Secretaries, taking into consideration (as applicable and to the extent feasible) any recommendations included in the report submitted by the Advisory Committee on Air Ambulance and Patient Billing under section 418(e) of the FAA Reauthorization Act of 2018 ( Public Law 115–254 ; 49 U.S.C. 42301 note prec.). Subject to paragraph (2), a provider of air ambulance services who fails to submit all information required under subsection (a)(2) by the date described in subparagraph

(A)or

(B)of subsection (a)(1), as applicable, shall be subject to a civil money penalty of not more than $10,000. In the case of a provider of air ambulance services that submits only some of the information required under subsection (a)(2) by the date described in subparagraph

(A)or

(B)of subsection (a)(1), as applicable, the Secretary of Health and Human Services may waive the civil money penalty imposed under paragraph

(1)if such provider demonstrates a good faith effort in working with the Secretary to submit the remaining information required under subsection (a)(2). The provisions of section 1128A of the Social Security Act ( 42 U.S.C. 1320a–7a ), other than subsections

(a)and

(b)and the first sentence of subsection (c)(1), shall apply to civil money penalties under this subsection in the same manner as such provisions apply to a penalty or proceeding under such section. The Secretary of Transportation may use any information submitted under subsection

(a)in determining whether a provider of air ambulance services has violated section 41712(a) of title 49, United States Code. Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall conduct a study and submit to Congress a report on options to establish quality, patient safety, service reliability, and clinical capability standards for each clinical capability level of air ambulances. Such report shall include analysis and recommendations, as appropriate, to Congress regarding each of the following with respect to air ambulance services: Qualifications of different clinical capability levels and tiering of such levels. Patient safety and quality standards. Options for improving service reliability during poor weather, night conditions, or other adverse conditions. Differences between air ambulance vehicle types, services, and technologies, and other flight capability standards, and the impact of such differences on patient safety. Clinical triage criteria for air ambulances. In this section, the terms group health plan , health insurance coverage , and health insurance issuer have the meanings given such terms in section 2791 of the Public Health Service Act ( 42 U.S.C. 300gg–91 ).

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