30 March 2023

March 31 Air Ambulance Reporting Deadline Delayed

In mid-March 2023, the Departments of Labor, Treasury, and Health and Human Services (collectively, the “Departments”) announced that group health plans will not be required to report certain information regarding air ambulance reporting for the 2022 calendar year on March 31, 2023.  Specifically, the Departments announced that the reporting deadline is delayed until final regulations are issued.  This announcement will likely be welcome news to group health plan sponsors, which may still be gathering data to comply with the reporting requirement.

Under the No Surprises Act (“NSA”), which became law as part of the passage of the Consolidated Appropriations Act, 2021 (“CAA”) on December 27, 2020, group health plans are required to report to the Departments the following information regarding air ambulance services:

  • Identifying information for the group health plan;
  • Market type (e.g., for self-funded group health plans, whether the employer is a small or large group employer);
  • Date of service;
  • Billing National Provider Identifier (“NPI”) information;
  • Current Procedural Terminology (“CPT”) code or Healthcare Common Procedure Coding System (“HCPCS”) code information;
  • Transport information (including aircraft type, loaded miles, pick-up and drop-off ZIP code; non-or-emergent transport, inter-facility transport, service delivery model (e.g., governmental, public-private partnership, etc.);
  • Whether the provider had a contract with the plan;
  • Claim adjudication information, including whether the claim was paid, denied, or appealed, the denial reason, and the appeal outcome; and
  • Claim payment information, including submitted charges, amounts paid by each payor, and cost-sharing information.

Group health plans may contract with their insurer (if fully insured) or third-party administrator (if self-funded) to satisfy the reporting requirement.  However, only agreements with an insurer will “legally” shift the reporting obligation.  Self-funded group health plans will need to rely on indemnification provisions to shift liability for compliance.  As mentioned above, under the NSA, the original reporting requirement for the 2022 calendar year was scheduled to be March 31, 2023.  However, the reporting deadline is now delayed until the Departments issue final regulations.

If you have any questions about the air ambulance reporting requirements or the deadline delay, please contact a member of the Miller Johnson Employee Benefits and Executive Compensation Practice Group.