Lynchburg, Va. — On Capitol Hill Tuesday, lawmakers planned a crack down on surprise medical bills for hospital services and treatments outside patient insurance networks. That includes air ambulance costs, which can cost more than $36,000.

When Joseph Penrod's son accidentally swallowed a bunch of prescription pills, his wife panicked.

"The first thing that she did was call poison control. And they talked to her about getting him to an ER as quickly as possible," Penrod said.

They didn't think twice when he was airlifted to a better hospital.

"They suggested that they were not appropriately equipped to deal with that particular age of patient in that particular condition," Penrod said.

His son was stable at the time and Penrod's insurance paid for the emergency room care. But he got slapped with a $40,000 bill for the air ambulance.

"I did not have $40,000 laying around. It would've destroyed us financially," Penrod said.

Air ambulances are often out of insurance network coverage because they are independent contractors and negotiate cost separately. They've become a growing lucrative business making most of their money in rural areas.

"The air transport industry, the predominant players are driven by private equity. The model is very simple. There are people out there in an emergency, they have resources, and we can take them," said Doug Gray, executive director of the Virginia Association of Health Plans.

Gray said a new Virginia law that went into effect March 1 will give patients the right to choose if they want to take an air ambulance in non-emergency situations and requires hospitals to disclose more cost information.

"An accident can happen any time, any place, and you could be the one who's having that decision made for you. And your livelihood, and your savings can be on the line," Gray said.

Penrod spent nearly a year fighting this bill. He finally offered to pay $1,000 and they took it.

"If you're rich, you can get a lawyer and that's great. If you're, if you're on the lower end of the spectrum, then you need to be able to fight for long enough to figure out how to escape," Penrod said.

