Air Ambulance Service

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.

States are responsible for regulating the medical services provided by air ambulance operators and the insurance issues related to those services. 

The No Surprises Act bans the practice of balance billing by air ambulance providers. A “balance bill” is a medical bill from an out-of-network provider for the portion of the provider’s charge that is not covered by the patient’s commercial health insurer or self-funded employer health plan, calculated as the difference between the provider’s charge and the amount allowed by the payor and the patient’s coinsurance and/or deductible. Under the No Surprises Act, States and the U.S. Department of Health and Human Services (HHS) enforce the ban on balance billing. To file a complaint under the No Surprises Act, please visit the Centers for Medicare & Medicaid Services website.

DOT’s Office of Aviation Consumer Protection (OACP) may pursue enforcement action against air ambulance operators who engage in unfair and deceptive practices. Complaints and comments related to those perceived practices may be submitted to OACP using on-line complaint form. Complaints are reviewed to determine whether an air ambulance is in compliance with federal law enforced by DOT protecting the rights of air travel consumers. Complaints are also used to track trends or spot areas of concern that serve as the basis for rulemaking, legislation, and research.

Air Ambulance Complaints

Provided below is a list of consumer complaints filed with DOT against air ambulance operators.

• 2024 Air Ambulance Complaint Data

• 2023 Air Ambulance Complaint Data

• 2022 Air Ambulance Complaint Data

• 2021 Air Ambulance Complaint Data

• 2020 Air Ambulance Complaint Data

• 2019 Air Ambulance Complaint Data

• 2018 Air Ambulance Complaint Data

Air Ambulance Advisory Committees 

On October 5, 2018, President Trump signed the FAA Reauthorization Act of 2018 (2018 FAA Act), Pub. L. No. 115-254, 132 Stat. 3186 (2018). Section 418 of the 2018 FAA Act required the Secretary of Transportation, in consultation with the Secretary of Health and Human Services, to establish an advisory committee to review options to improve the disclosure of charges and fees for air medical services, better inform consumers of insurance options for such services, and protect consumers from balance billing. The Air Ambulance and Patient Billing (AAPB) Advisory issued its recommendations in March 2022. Click here for more information about the AAPB Advisory Committee.

The No Surprises Act directed HHS and DOT to jointly establish an Advisory Committee on Air Ambulance Quality and Patient Safety (AAQPS). Click here for more information about the AAQPS Advisory Committee.