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According to Verticle Magazine, Air ambulance providers in the United States could soon be required to distinguish between charges for air transportation and medical services in the bills they send to patients and insurers.

H.R. 4, the Federal Aviation Administration (FAA) Reauthorization Act recently passed by the U.S. House of Representatives, calls for federal rulemaking to require air ambulance operators to “clearly disclose charges for air transportation services separately from charges for non-air transportation services within any invoice or bill.”

Crucially, H.R. 4 also specifies that the “non-air transportation services” of air ambulance operators — and the prices thereof — are neither services nor prices of an air carrier for purposes of the Airline Deregulation Act (ADA). That could potentially open the door to state regulation of air ambulance billing — something that until now has been preempted by the ADA.

Read More: FAA Modifies Restrictions on Drone Operations

The Association of Air Medical Services (AAMS) and a related organization, Save Our Air Medical Resources (SOAR), are campaigning hard against the language in H.R. 4, warning that it would lead to “a patchwork of inconsistent state regulations” that could actually “put lives at risk” by impeding the transport of patients across state lines. SOAR represents some of the nation’s largest for-profit air medical operators, including Air Methods, PHI Air Medical, and Air Medical Group Holdings.

However, others in the industry have suggested that these fears are overblown. According to the Association of Critical Care Transport (ACCT) — which represents about 80 air and ground medical transport providers, many of them nonprofit or hospital-based — “there is nothing in the adopted House language which will change normal practice of serving critically ill and injured patients within and across state lines.”

With the Senate now considering its own version of the FAA Reauthorization Act, ACCT is urging Senators to retain the House language, arguing that it “effectively clarifies the appropriate role of state regulatory authorities in licensing and overseeing air medical programs . . . while protecting vulnerable patients in emergent events.” Continue reading about H.R. 4 and air ambulance industry.