Anyone who has been picked up by a medical helicopter and transported to a hospital after an accident can come into a big surprise when they get the bill. Today there is a culture of high competition in a market place that is over gutted with helicopters. The victim does not call for helicopter service; that decision is made by a first responder who assesses the patient and makes the call for transport. In some instances, a helicopter may not have been necessary in the first place. An ambulance may have been able to transport in a more timely fashion or the victim’s injuries really did not qualify for trauma intervention. An injury can be a highly emotional situation fed by fear of loss of life. Typically, insurance does not provide for helicopter transport and a victim really has no real understanding of what they are in for. Unfortunately, federal law has often preempted state regulations that might otherwise protect consumers. Clearly there needs to be some kind of protection in place so that the patient does not end up with extreme medical bills and no way to pay. Lawsuits abound in the industry. At this point in time, higher Medicare reimbursement rates along with minimal regulation has transformed an essential life-saving service into one with little oversight, multiple accidents claiming lives and predatory billing practices.