good morning your honor may it please the court to challenge regulations which govern compensation for air ambulance services provided to members of west virginia medical benefits and workers compensation plans are consistent with how that state tre airline deregulation act reflects a decision to allow free market forces to substitute for federal and state regulation in the specific context of interstate passenger and cargo transportation nothing about the t provision or the purpose and structure of the statute supports applying preemption to the air ambulance contracts which involves medical services an area in which states have traditionally regulated which are predominantly in trust state nothing in that x speaks to the particular authorization or air taxis an air ambulance is it also does not touch the preemption provision even though congress is acting in a time when there are significant litigation about this very question in courts nationwide all it did in fact was provide what you have to understand the purpose price control it wanted neither the states or the federal government to regula yes over over other provisions and yes that authority does extends to both area ambulances and airlines generally but in the particular context of price controls congress said that even the federal government should not be setting ice for interstate airlines enjoins the feast schedules and sounds which puts west virginia in a very difficult position because it's unclear what what rate if any west virginia is required to pay the district court and let me ask this question which i matter or third party it cannot exceed the ring and that's that's the great reading of that statute as well yes and so the balance billing provisions really are sort of a separate story because what that is that means regardless of balance that if an air ambulance company or any other medical provider that instance chooses to accept reimbursement under their plan they also may not receive additional compensation correct but here's what they can't do what a private insurer can't do is say yes here's the amount we'll and they're not authorized under the sub part to provide transportation or evacuate to the neighboring sub parts three and sub one event does have a sub par three safety certificate but all airlines all air carriers have that that's or yes but nothing in some part to give them that optimisation congress the city looked at this argument of whether the preemption provisions should include certificates and exemptions or just certificate the senate language would have burdensome requirements you mentioned are very real and it makes sense that this regime congress set in place it makes sense to say that congress would have said traditional interstate passenger and cargo airlines undergo extensive federal certification would be a circuit conflict but the reality is the majority of courts to look at this issue they didn't look at the authorization issues that really the issue was conceded or was not really good that was true of the eleventh circuit decision and dail in the reason for that is twofold one is that we play a leading in the alternative as opposed to the actual killing provisions because we don't want to be in the middle it's specifically for workers comp if you actually employer and so going with the the the schedule piece does the least harm to the overall purpose of the act now the state of west virginia has full of billeted to change that as long as they want to so that is true your honor and we believe that the express preemption provision under the puerto rico decision from the united states supreme court in of the trilogy of cases from the united states supreme court shows the congress having expressed purpose here in the presumption doesn't apply moral argument was made the presumption should apply the court of norden argument will once the argument was made the presumption should apply the court ignored that argument against bert the argument was made the presumption should apply and we're agreed if we chose to follow a presumption carriers which are passengers planes that will sixty passengers or less and in the polling sixty passengers or less there are seventy nine air carriers that are registered as commuter air carriers or part two and yet so they don't have a four eleven six certificate they sea preemption that includes united express moving from texas to louisiana or texas to oklahoma that includes a number of air carriers you've heard it also includes our two ninety four certificate holders which are canadian air operators that are coming into the united states there's just shy of three hundred of those those would no longer pursue preemption would have states like wyoming regulating and dealing with diplomatic issues but literally section two subs so part to deal with so i think your farm points a really good one  services so it includes medical site it includes states all of that is supposed to culminate in a report the secretary of transportation gives to congress and that report is in section four twenty in the contents of it and i think that the contents of that report is the most instructive thing about what congress thought about preemption provision and judge floyd this goes to your question that you asked for it from the very beginning the contents of the report that the secretary of transportation is supposed to give to congress a timeline for the issuance of any guidance concerning unfair and deceptive trade practices among air ambulance providers key language including guidance for the state in political subdivisions of state same language it's in the preemption provision to refer such matters to the secretary which means deceptive practices unfair practices pricing issues the state is supposed to refer those to the secretary and the secretary supposed to work with the states to figure out the right way to do that that subject to regulation under that court said no here there are at least seven or eight provisions in support two that i can name out that were subject to regulation or two ninety eight certificate holders are subject to regulation those have been augmented in a min did also part two pieces of the legislation in two thousand and eighteen but more importantly and i think this is probably what kind of puts the linchpin in in our argument that is there was no such thing as so part one could a state like west virginia adopt a law that sets the rates for erin whether directly or by delegation to agency to set the actual rate that they set the rate that for example the will reimburse for air ambulance service but does nothing with respect to third party reimbursement or employee reimbursement it literally just says the p e a will pay i'm having trouble understanding is why does the rate schedule itself also so we played in the alternative we played the rate schedules to be predicted and that was what we asked the courts to and that's what the court found at the end of this order he said i'm not addressing the e i that would be correct but that would put the patient right in the middle so that's that's totally true but for us to question seems like me is under west virginia law is that the so we're certainly not saying that now the judge written richardson's question i think the question gets a little more complicated as workers compensation you know last five try to stay away from that it gets much more complicated for workers compensation but we're certainly not saying that if they wanted to come to the table when they were three hundred they're p e i a plan which is just like an insurance plan they want they're going to pay x and then we can go to the employee that's the state of west virginia choice to do that we do we would hope that they wouldn't there's lots of insurers that do not do that there are some absolutely in and we completely agree with with that i do want to address just for one more minute the the under the sun our argument for for one last minute counsel macian the senate version made the entire idea of where your certificate comes from would have no doubt they would have no ability to make that argument host pre one thousand nine hundred four and nothing was intended to change in one thousand nine hundred four when the support one two three and four was created briefly several that you actually well no your honor we expressly made the argument that balanced billing provisions are all right the provisions that require ambulances not to go after any other parties for any amount of up at least that that is the most that should be enjoin chaos that is seen to be concerned about congress is predominantly concerned in the about overlapping regulation in a predominately interstate market where certain airlines also serve to kill or cities within the same state that's flipped medicare feast schedule that includes rights for air ambulance services the same congress that said that there should be no federal or state regulation or the rates of a traditional air carrier seem to find no inconsistency with those fee schedule that's exactly what's happening here the chaos would be to allow the district court's decision to stand which currently says that congress and private insurers can enforce rules but states uniquely cannot that's the absurd and chaotic w