Legislation
The Emergency Air Rescue Alliance is working to support two pieces of federal legislation that fix how emergency air medical care is paid for, without creating a single new government program or a dollar of new spending. Together, the LIFELINE Act and the PATH Act make insurers play fair and keep patients out of the middle of billing disputes.
The LIFELINE Act
Lifesaving Infrastructure and Fair Emergency care Legislation for Insurer Noncompliance Enforcement Act
Why It’s Needed: When Congress passed the No Surprises Act, it created a federal arbitration process, called Independent Dispute Resolution, to settle payment disputes between air medical providers and insurers. On paper it protects patients and gives both sides a fair hearing. In practice, insurers can ignore the outcomes with little consequence. The LIFELINE Act gives that process real teeth.
What It Does:
Makes arbitration decisions enforceable in court, with interest and legal costs. Unpaid awards can be enforced under the Federal Arbitration Act, and courts can add 10 percent annual interest plus the prevailing party's attorney's fees.
Creates a direct right to sue when an insurer violates the No Surprises Act, so an injured party can seek damages in federal court.
Gives air medical providers a clear path when an insurer refuses to even take part in arbitration.
Closes the "eligibility gambit," where an insurer makes a partial payment and then claims the care was never covered. Under LIFELINE, a partial payment counts as an admission of coverage.
Stops arbitration bodies from acting as gatekeepers by second-guessing coverage before a dispute can be heard.
Protects state-law claims from being wiped out by federal airline-deregulation preemption.
Why it matters: No new spending. Just fair payment. The LIFELINE Act does not create a new program or cost taxpayers a dollar. It simply enforces the rules Congress already wrote, so the air medical bases that rural communities depend on can survive. And it never targets patients: every enforcement tool in the bill runs between providers and insurers.
Status: The LIFELINE Act is being developed with congressional allies and has not yet been formally introduced. We are actively building support in both the House and the Senate.
The Path Act
Patient Assignment of Treatment and Healthcare Claims Act
Why It’s Needed: When a patient receives emergency air medical care from an out-of-network provider, they should be able to hand their insurance claim directly to that provider and let the provider deal with the insurer. Many health plans block this with "anti-assignment" clauses, forcing patients to pay large bills upfront and then fight their own insurer for reimbursement, often while they are still sick or recovering. The PATH Act ends that practice.
What It does:
Bans anti-assignment clauses. Health plans and insurers can no longer stop a patient from assigning a claim or benefit to a non-participating provider for covered services.
Closes the loophole everywhere it hides, by amending the three federal laws that govern health coverage: the Public Health Service Act, ERISA, and the Internal Revenue Code.
Takes effect for plan years beginning on or after January 1, 2027.
Who It protects:
Patients no longer have to pay upfront and fight for reimbursement while recovering.
Employers keep the freedom to design health plans for their employees without being dragged into payment disputes.
Providers get a direct, straightforward path to payment for care they have already delivered.
Why it matters: This is especially important for the roughly half of Americans covered by employer-sponsored ERISA plans, where current federal law bars providers from dealing directly with the plan, leaving patients to carry the burden. The PATH Act puts the patient back where they belong: out of the middle.
Status: The PATH Act exists in draft form and has not yet been formally introduced. We are building support to move it forward.