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Workers’ compensation
insurers just secured a major victory in the Texas air ambulance
litigation. On January 16, 2026, the State Office of Administrative
Hearings (SOAH) issued decisions in the two major groups of air ambulance cases
pending at SOAH.
In both cases, the Administrative Law Judges (ALJs) found that for the years in
issue from 2011 – 2013, fair and reasonable reimbursement for the base rate
ranges from 128.8% to 139.3% of Medicare and the mileage rate ranges from
119.1% to 128.8%. The ALJs rejected the air ambulance providers’ proposed
reimbursement that ranged up to more than 500% of Medicare for the average
total rate. SOAH previously rejected the air ambulance providers’ argument that
the federal Airline Deregulation Act (ADA) preempts the “fair and reasonable”
reimbursement standard and therefore, they should be paid their full billed
charges.
The decisions issued by SOAH in these cases are notable for the depth of their
analysis, each over a hundred pages, which followed a four-day hearing in the
first case and a three-day hearing in the second case, both with numerous
expert and fact witnesses. Texas Mutual, which has around a 40% market
share, should be commended for doing the heavy lifting in these cases.
The air ambulance providers, which are private equity-owned, will likely appeal
these latest SOAH decisions in their ongoing effort to extract more money from
the Texas workers’ compensation system.
As of December 2025, there are 2,183
air ambulance disputes at DWC, dating back to at least 2014, and this number
will continue to rise as the air ambulance providers file new disputes.
Copyright 2026, Stone Loughlin & Swanson, LLP