UNITED STATES DISTRICT COURT 

NORTHERN DISTRICT OF FLORIDA 

TALLAHASSEE DIVISION 

AIR METHODS CORPORATION and 

ROCKY MOUNTAIN HOLDINGS, 

 Case No. 4:20-cv-00462-AW-MAF 

Plaintiffs, 

vs. 

DAVID ALTMAIER, in his official 

capacity as Commissioner of the 

Office of Insurance Regulation, 

 

Defendant. 

___________________________________/ 

PLAINTIFFS’ NOTICE OF NEW FEDERAL LAW 

REGULATING AIR AMBULANCE REIMBURSEMENT AND BILLING 

Plaintiffs Air Methods Corporation and its wholly-owned subsidiary Rocky 

Mountain Holdings LLC (collectively, “Air Methods”) respectfully provide the 

Court with notice regarding the passage of the No Surprises Act (the “Act”), that was 

signed into law on December 27, 2020, as part of the Consolidated Appropriations 

Act (HR 133). A copy of the relevant excerpts from the Act is attached as Exhibit 

A.1

 

 

1

 At the time of the hearing before the Court on December 14, 2020, on the pending 

Motion to Dismiss, Plaintiffs’ counsel mentioned that it appeared that federal 

legislation may be forthcoming, but nothing was certain at that time. The Court 

expressed interest in hearing about any new legislation that becomes new law. 

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The new legislation, effective in January 2022, is intended to protect 

consumers from surprise bills for: (1) emergency services delivered by out-ofnetwork providers, including emergency air ambulance operators, or by out-ofnetwork facilities; and (2) nonemergency services provided by out-of-network 

providers in network facilities and for which patients do not consent. Consumers’ 

costs will be limited to cost-sharing amounts that apply to in-network services. 

Significantly, service providers are banned from billing patients for any higher 

amounts. 

Section 105 of the Act, titled “Ending surprise air ambulance bills,” 

specifically covers and preempts the reimbursement and billing rules enacted by the 

Florida Legislature in Florida Statutes §§ 627.42397 and 641.514 (“HB 747”). 

Section 105 holds patients harmless from surprise air ambulance medical bills and 

only requires them to pay the in-network cost-sharing amount for out-of-network air 

ambulances. That cost-sharing amount is applied to their in-network deductible. Air 

ambulances are barred from sending patients surprise bills for more than the innetwork cost-sharing amount. 

The new federal law also provides for a 30-day open negotiation period for 

air ambulance providers and payers to settle out-of-network claims. If the parties are 

unable to reach a negotiated agreement, they may access binding arbitration through 

an Independent Dispute Resolution (“IDR”) process. By January 21, 2022, the 

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Secretary of Labor and Secretary of Transportation are to jointly establish by 

regulation the specific IDR process under which, in the case of air ambulance 

services, a certified IDR entity will determine the amount of payment under the plan 

or coverage for such services. 

The impact of the Act on this case is evident. While HB 747 is expressly 

preempted under the Airline Deregulation Act for attempting to regulate Air 

Methods’ prices and services, the Act further confirms federal preemption on 

conflict and field preemption grounds. Congress specifically enacted a federal 

statute to address the very issues that are at the heart of the Florida law. In its 

Complaint, Air Methods advised the Court and parties of the federal government’s 

pervasive regulatory role and formation of the Air Ambulance and Patient Billing 

Committee, which was organized to specifically address billing issues at the federal 

level. 

In light of the foregoing, Air Methods has contacted counsel for Defendant 

Commissioner Altmaier to determine whether he would agree to stipulate that HB 

747 is federally preempted and void. While the new federal law does not take effect 

until January 1, 2022, it soundly demonstrates the overarching federal regulatory 

role in this area and preemption of any state laws on these issues. Additionally, Air 

Methods had asked whether the Commissioner would oppose a motion to amend the 

Complaint to add facts and claims regarding the new federal law. 

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The Commissioner objects to the motion to amend the complaint at this time, 

stating that it would not be appropriate considering the posture of this case. In the 

Commissioner’s view, his motion to dismiss is fully briefed and based on arguments 

directed to jurisdictional issues of ripeness and standing. The Commissioner 

considers the proposed amendments to the Complaint as pertaining to the merits of 

the claims and thus, any amended complaint would be subject to the same 

jurisdictional arguments as the original Complaint. 

March 3, 2021 Respectfully submitted, 

 HOLLAND & KNIGHT LLP 

Attorneys for Plaintiffs 

/s/ Tiffany A. Roddenberry 

Tiffany A. Roddenberry 

Florida Bar No. 92524 

Email: Tiffany.Roddenberry@hklaw.com 

315 South Calhoun Street, Suite 600 

Tallahassee, FL 32301 

Tel: (850) 224-7000 

Judith R. Nemsick (admitted pro hac vice) 

Email: judy.nemsick@hklaw.com 

31 West 52nd Street 

New York, NY 10019 

Tel: (212) 513-3200 

Philip E. Rothschild 

Florida Bar No. 88536 

Email: phil.rothschild@hklaw.com 

Secondary email: 

carmen.ramsey@hklaw.com 

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515 East Las Olas Boulevard, 12th Floor 

Fort Lauderdale, FL 33302-4070 

Tel: (954) 525-1000 

CERTIFICATE OF COMPLIANCE WITH LOCAL RULES 

AND CERTIFICATE OF SERVICE 

Pursuant to Local Rule 7.1(B), I hereby certify that the parties have conferred 

and that Defendant’s position is reflected in this Notice. 

The undersigned certifies that the foregoing complies with the size, font, and 

formatting requirements of Local Rule 5.1(C), and that the foregoing complies with 

the word limit in Local Rule 7.1(F); the foregoing contains 709 words, excluding the 

case style, signature block, and certificates. 

I also certify that a true and correct copy of the foregoing was served to all 

counsel of record through the Court’s CM/ECF system on March 3, 2021. 

/s/ Tiffany A. Roddenberry 

Tiffany A. Roddenberry 

Florida Bar No. 92524 

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