Understanding the U.S. Department of Transportation's Office of Aviation Enforcement and Proceedings

Explore the functions and structure of the U.S. Department of Transportation's Office of Aviation Enforcement and Proceedings (OAEP). Learn about its role in handling air ambulance consumer complaints, enforcing regulations, and ensuring aviation consumer protection through various compliance methods. Discover how DOT statutory authority empowers the office to address unfair practices in air transportation.

• Aviation Enforcement
• U.S. Department of Transportation
• Consumer Protection
• Air Ambulance
• Compliance Methods

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1. Air Ambulance and Patient Billing Advisory Committee Air Ambulance Consumer Complaints January 16, 2020 U.S. Department of Transportation Office of Aviation Enforcement and Proceedings Robert Gorman, Senior Attorney 1

2. Presentation Overview Introduction to DOT s Enforcement Office DOT Statutory Authority Unfair and Deceptive Practices DOT Complaint Handling Process DOT Air Ambulance Complaints Other Sources of Air Ambulance Complaints 2

3. What is the Office of Aviation Enforcement and Proceedings ( OAEP or Enforcement Office )? Simplified Structure Office of the General Counsel Office of the Secretary (OST) USDOT FAA OAEP! 3

4. Office Structure Assistant General Counsel Deputy AGCs Directors of Consumer Advocacy and Civil Rights Advocacy Staff Attorneys Paralegal Transportation Industry Analysts Consumer Affairs Specialist Consumer Affairs Analyst 4

5. Office of Aviation Enforcement and Proceedings Subject Areas: Aviation Consumer Protection Civil Rights (Disability and Discrimination) Competition Practice Areas: Enforcement, Rulemaking, Guidance, Outreach (e.g. industry and public communications), Complaint Handling 5

6. Office of Aviation Enforcement and Proceedings Web site: www.transportation.gov/airconsumer Helpful travel information Air Ambulance page: https://www.transportation.gov/individuals/aviation- consumer-protection/air-ambulance-service Complaint Portal 6

7. 7

8. Compliance Methods Direct Communications with Carrier Industry Notices and Guidance Warning Letters Enforcement Action Consent Orders Formal Adjudication 8

9. DOT Statutory Authority 49 U.S.C. 41712(a) Authorizes the Secretary to investigate and decide whether an air carrier, foreign air carrier, or ticket agent has been or is engaged in an unfair or deceptive practice or an unfair method of competition in air transportation or the sale of air transportation. DOT may take action on its own initiative or via complaints 9

10. DOT Statutory Authority Air carrier: a citizen of the United States undertaking by any means, directly or indirectly, to provide air transportation. (49 U.S.C. 40102) 10

11. DOT Statutory Authority Unfair or Deceptive Practice: Terms not formally defined by statute or regulation DOT intends to issue Notice of Proposed Rulemaking (NPRM) defining these terms (RIN 2105-AE72) 11

12. DOT Statutory Authority Unfair or Deceptive Practice: DOT uses FTC s definitions of unfairness and deception A practice is unfair to consumers if it causes or is likely to cause substantial injury, which is not reasonably avoidable, and the harm is not outweighed by benefits to consumers or competition. A practice is deceptive to consumers if it is likely to mislead a consumer, acting reasonably under the circumstances, with respect to a material matter. A matter is material if it is likely to have affected the consumer s conduct or decision with respect to a product or service. 12

13. DOT Statutory Authority Unfair or Deceptive Practice: Practice not defined by DOT or FTC 13

14. DOT Statutory Authority 49 U.S.C. 41712(a) Authorizes DOT to order the air carrier to stop the unfair or deceptive practice Notice and opportunity for a hearing 49 U.S.C. 46301: Civil Penalties Limits on penalty structure 14

15. DOT Complaint Handling Process Consumer files written complaint with DOT DOT forwards complaint to carrier Carrier must respond substantively to consumer and DOT within 60 days Enforcement: Pattern or Practice 15

16. DOT Air Ambulance Complaints July 2017: Government Accountability Office (GAO) recommended that DOT communicate a method to receive air ambulance complaints through a dedicated web page, with instructions on how to submit complaints and information on how DOT uses the complaints 16

17. DOT Air Ambulance Complaints DOT Air Ambulance Consumer Complaints Info available from Enforcement Office home page at https://www.transportation.gov/airconsumer Complaints Tracked at https://www.transportation.gov/individuals/av iation-consumer-protection/air-ambulance- service Updated Monthly 17

18. DOT Air Ambulance Complaints DOT Air Ambulance Complaint Handling Process Similar to Consumer Complaints: DOT asks for air ambulance invoice from consumer DOT requests response from air ambulance provider DOT attempts to track outcomes 18

19. DOT Air Ambulance Complaints DOT Air Ambulance Consumer Complaints 2018: 24 Received 2019: 34 Received (26 posted; 8 posted soon) Great Majority Involve Balance Billing Others include: bill collection; consent; lack of advance notice of charges; failure to bill Medicare) 19

20. DOT Air Ambulance Complaints 2019 Outcomes: 26 Complaints Posted 12 Favorable Outcomes (bill reduced substantially or to zero) 5 Unfavorable (3 allegedly because insurance won t negotiate) 9 Miscellaneous (mistakes; patient untrackable, etc.) 20

21. Other Recipients of Air Ambulance Complaints State Insurance Commissioners/AGs Maryland: ~24 complaints from 2014-2018* North Dakota: ~36 complaints from 2014-2018* Air Ambulance Providers Consumer Reports/BBB/Consumer Advocates/News Nonprofit health advocacy organizations (e.g., Patient Advocate Foundation; New York Community Health Advocates) Per 2019 GAO report: https://www.gao.gov/assets/700/697684.pdf 21

22. Questions? 22