CHEYENNE, Wyo. — The state of Wyoming is scrambling to try to block a federal judge’s ruling that the state may not regulate how much air ambulance companies charge for transporting workers who are injured on the job.

The state is asking a federal appeals court in Denver to block this summer’s ruling by U.S. District Judge Alan B. Johnson of Cheyenne that federal law prohibits state regulation of air ambulance companies. The companies are due to file a response later this week.

Health care providers, including ambulance services, generally submit bills for treating Wyoming workers injured on the job to the state’s workers’ compensation program. A state law specifies that it’s up to the director of the state’s Workers’ Compensation Division to determine reasonable charges for the flights.

But Johnson ruled that a federal law Congress passed in the 1970s specified that states may not enact or enforce laws or regulations regarding price, routes or service of air carriers. He ruled Wyoming’s attempt to regulate air ambulance companies violated that federal law and ordered the state to pay the rates that the air ambulance companies charge.

In their lawsuit against Wyoming, four air ambulance companies claimed the state owes them about $2 million for past flights. The companies have argued Wyoming capped what it would pay for air ambulance services at just over $3,900 per flight. The companies had submitted bills that sometimes exceeded $40,000 per flight.

The companies are: EagleMed, based in Kansas; Air-Methods Corp., and Rocky Mountain Holdings, both based in Colorado; and Med-Trans Corp., based in Texas. Attempts to reach lawyers for the companies for comment were not immediately successful.

Wyoming Attorney General Peter Michael declined to comment on the state’s appeal.

The Wyoming AG’s Office last week filed a written argument with the 10th Circuit Court of Appeals in Denver asking it to block Johnson’s order. The state argued that the federal Airlines Deregulation Act, “does not grant air ambulance companies a federal right to payment by the states, whether it be the total amount charged or otherwise.”

Sen. Jon Tester, D-Mont., has pushed legislation — unsuccessfully so far — that would allow states to determine whether they wanted to enact rules regarding air ambulance rates and services. He has called for a federal investigation into the costs of operating air ambulances, a proposal his office says is still awaiting a final vote in the Senate.

“Out-of-control air ambulance bills are forcing families into financial uncertainty and it is critical that we continue to take steps that will ensure folks don’t face bankruptcy after surviving a medical emergency,” Tester said in a prepared statement Monday.

State officials in Montana also are working to address the issue of high air ambulance fees. A working group, set to meet in Helena on Tuesday, is considering a proposal that would require insurers and out-of-network air ambulance service providers to negotiate a payment. That would leave the patient responsible only for the deductible and co-insurance costs required under their policies. The legislation would require an independent review if negotiations fail.

The Montana Legislature’s Economic Affairs Interim Committee appointed the Air Ambulance Working Group to try to develop a solution after residents complained about receiving bills for tens of thousands of dollars from air ambulance companies after their insurance companies paid a fraction of the amount. The air ambulance companies say insurers won’t agree to adequate payments, and insurers argue providers won’t disclose their actual costs so they can set reasonable rates.


Amy Hanson in Helena, Montana contributed to this report.