ATHENS COUNTY, Ohio — In 2021 and 2022, four different Athens County men suffered life-threatening traumas that required emergency medical transportation to hospitals in Columbus, via MedFlight of Ohio.
What the men didn’t know was how much those flights would cost them. The flights were only partially covered by insurance, leaving each man with unexpected — and eye-watering — medical bills.
And now MedFlight of Ohio is suing each of the four men for their unpaid bills: the full price of the transport, plus 3% interest on top of the original bill.
Two of the lawsuits, filed in the Athens County Court of Common Pleas, seek $27,456 and $30,293 from two Albany men. An Albany man and an Athens resident are being sued in Athens Municipal Court for $6,726 and $2,068, respectively.
“In each of these situations, MedFlight did not receive the patient’s portion of the payment for the care and transport services provided despite numerous attempts to contact these patients,” MedFlight’s legal representative Ari Witkes stated in an email.
This isn’t the first time MedFlight has sued Athens County residents. The company is shown as the plaintiff or creditor in four closed cases in the county Court of Common Pleas, dating back 20 years. In one of those cases, MedFlight sued the estate of an Athens County woman who died the year before.
More recently, the company won a judgment against an Athens man for a July 2022 transport. The man was ordered to pay $34,048 plus 3% interest, as well as MedFlight’s court costs. A June 2021 transport cost an Athens woman $33,130 plus 8% interest and all court costs. As in the current cases, MedFlight was represented by Witkes Law Firm.
According to court documents, none of the local defendants had attorneys.
MedFlight declined to comment for this story, as did the Ohio Ambulance and Medical Transport Association, an EMS services advocacy group. Athens County Emergency Medical Services did not respond to a request for comment.
A nationwide problem
The high cost of emergency medical transport is a national problem. “Charges for air ambulance transports are typically substantial and have been increasing,” the U.S. Department of Health and Human Services reported in 2021. However, the Airline Deregulation Act of 1978 prohibits states and the federal government from imposing fee caps.
The problem is compounded by insurance limits on in-network and out-of-network providers; out-of-network providers are more expensive. But “patients generally do not have a choice about which air ambulance provider/supplier to use or information about whether their insurance will cover the trip,” according to the U.S. Department of Health and Human Services.
The Department of Health and Human Services’ issue brief states that high air transportation costs are related to a nationwide shift from nonprofit air ambulance services to hospital-related for-profit or venture capital firms. Private for-profit medical transportation companies often are out-of-network for health insurance companies.
An internal HHS analysis of 2016 data suggested that over 50% of air ambulance transports are out-of-network. The General Accounting Office estimated that 69% of transports of privately-insured individuals in 2017 were out-of-network.
Both Congress and the Ohio Legislature have moved to protect patients from unreasonably high bills from out-of-network providers. In 2020, Congress passed the No Surprises Act to protect people on most insurance plans against surprise bills (an unexpected bill from an out-of-network provider) for a large range of emergency services, including ambulance and air-lift transportation. The following year, the Ohio Legislature passed its own nearly identical surprise billing law. Both pieces of legislation had the same effective date of January 1, 2022.
“The No Surprises Act protects insured consumers from paying more than they would have otherwise paid had they been provided an in-network service,” Athens Legal Services attorney Charles Cohara told the Independent. “The consumer would still be responsible for their co-insurance, co-pay or deductible. If a consumer is uninsured, they may be entitled to a good faith estimate prior to the rendering of services.”
However, MedFlight’s lawyer says those laws don’t apply to the open Athens County cases.
“Neither of these two laws are applicable for any care or transport services provided to these individuals,” Witkes stated.
Cohara said the reason is that the defendants’ services occurred before the law’s enactment.
“It appears that in some of the cases services were provided prior to that date,” Cohara said. “So the NSA probably does not apply.”
Furthermore, if a third-party payor is involved, there might be further stipulations.
“In the [McKenzie case], there appears to be a third-party payor [Industrial Commission], so as long as the amount charged to the patient is no different than one charged to one who received in network services, the law may have been met,” Cohara said.
Med Flight corporate structure
MedFlight is a trade name owned by Ohio Medical Transportation, a not-for-profit organization that dates back to 1997. As a not-for-profit entity, Med Flight has been tax exempt since 1996. As such, they do not pay federal income taxes on their earned revenue. In FY 23, MedFlight earned a total revenue of $49 million.
According to its website, MedFlight is “governed by our owner healthcare networks: OhioHealth and The Ohio State University Wexner Medical Center, with additional support from affiliate-member Kettering Health Network.” OhioHealth owns O’Bleness Memorial Hospital in Athens; Holzer Health System, which has an urgent care center in Athens, is listed as a partner hospital.
Ensuring coverage by any branch of MedFlight within Ohio requires purchase of a yearly “Advantage Membership” at a cost of $70 per year. An “Advantage Global Membership,” which covers transportation out of state or internationally, costs up to $370 per year.
According to 2023 revenue and tax documents, MedFlight brought in nearly $48 million in “program services” — income derived from billing for emergency transportation — in 2023. That figure comprised approximately 97.7% of the company’s gross reported revenue that year. MedFlight’s net revenue in 2023 was $1.04 million.
