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Air Ambulance Cost Control – Wyoming’s Effort Fails


The state of Wyoming has led the effort to control air ambulance costs and had earlier appealed for a relook into the Federal Government’s policy of keeping this aspect out of state governments’ control. However, the latest development in this regard shows that the effort has failed completely. The air ambulance industry was not at all happy about the move made by Wyoming. The industry had found support from several corners in the medical community too. The insurance industry had shown support to the state of Wyoming wherein all the air ambulance service providers would have been compelled to come under insurance networks.

What Air Ambulance Industry Changes had been sought?

The federal law prohibits states to regulate the airline industry in any manner. Since air ambulance services also come under the airline industry, the states cannot have a say in matters pertaining to them. In order to circumvent this hurdle, states like Wyoming had sought to get a 1115 waiver, which makes way for states to implement experimental or pilot programs with the intention to improve care. Under this exemption, the state had wished to convert ambulance services into essential services, bringing them under Medicaid. However, CMS which oversees Medicaid, has now rejected this proposal.

Why was the Proposal Rejected?

The waiver was sought by the Wyoming government on 28th of December last year. and it was rejected on January 3rd of this year. The primary reason cited for the rejection was the state had failed to indicate that the proposed program was budget-neutral. Also, some medical institutions and professionals had openly opposed the proposal. They had gone a step further by writing to CMS about their apprehensions. Their main concern had been that it would limit the reach and quality of care.  The state, however, has indicated that it would pursue the matter further.

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