Missouri enacts rules for air ambulance membership agreements and Medicaid enrollment

The Missouri State Legislature has introduced House Bill 991, aimed at regulating air ambulance membership agreements in relation to the state's Medicaid program, MO HealthNet. Introduced on March 3, 2025, the bill seeks to clarify the relationship between air ambulance services and Medicaid coverage, addressing concerns about potential confusion among enrollees.

The primary purpose of House Bill 991 is to ensure that individuals enrolled in MO HealthNet are fully informed about their rights and the nature of air ambulance membership agreements. Key provisions of the bill mandate that all marketing materials and membership applications for air ambulance services clearly disclose that these agreements are not insurance and that MO HealthNet covers air ambulance transport without any out-of-pocket costs for enrollees. Additionally, the bill stipulates that individuals who are currently enrolled in Medicaid cannot be offered or accepted into air ambulance membership programs.

Notably, the bill requires that air ambulance membership organizations provide a clear process for enrollees to notify them if they become enrolled in MO HealthNet, with a provision for prorated refunds if this notification is made in a timely manner. If enrollees believe their rights under this bill have been violated, they are empowered to file complaints with the state attorney general's office.

The introduction of House Bill 991 has sparked discussions among lawmakers and stakeholders in the healthcare sector. Supporters argue that the bill is a necessary step to protect vulnerable populations from misleading marketing practices and to ensure that they are aware of their benefits under Medicaid. Critics, however, express concerns that the bill may limit access to air ambulance services for those who may benefit from membership agreements, potentially leading to gaps in emergency medical care.

The implications of this legislation are significant, as it seeks to balance the interests of air ambulance service providers with the rights of Medicaid beneficiaries. As the bill moves through the legislative process, its outcomes could reshape how air ambulance services operate in Missouri, particularly in relation to Medicaid enrollees. The ongoing debates surrounding the bill will likely influence its final form and implementation, making it a key issue to watch in the coming months.