Individual States are responsible for regulating the medical services provided by air ambulance operators and the insurance issues related to those services. The U.S. Department of Transportation (DOT) has limited authority under the Airline Deregulation Act to regulate the prices, routes, or services of an air carrier, including an air ambulance operator, in air transportation. However, DOT’s Office of Aviation Enforcement and Proceedings may pursue enforcement action against air ambulance operators that engage in unfair and deceptive practices. Complaints and comments related to those perceived practices may be registered with the Office’s Aviation Consumer Protection Division at: https://airconsumer.dot.gov/escomplaint/ConsumerForm.cfm. Complaints are examined to determine the extent to which an air ambulance is in compliance with federal law enforced by the Department protecting the rights of air travel consumers. They are also used to track trends or spot areas of concern that serve as the basis for rulemaking, legislation, and research.