Ohio Attorney General Dave Yost filed a lawsuit against Superior Air-Ground Ambulance Service on June 5, 2026, accusing the company of concealing its out-of-network status from patients and then billing them hundreds or thousands of dollars after transports were already complete. The Superior Ambulance lawsuit, filed in Franklin County Common Pleas Court as case number 26CV005143, is the latest in a string of legal actions against the Midwest’s largest private ambulance provider, which has also paid a $3.2 million data breach settlement and a separate Medicare billing settlement in recent years.
What Ohio Is Alleging
The complaint says Superior transported patients between medical facilities without ever telling them it was out of network for all private health insurers. According to the Attorney General’s office, the company failed to provide cost estimates before service and presented payment authorization forms only after the ride was over. Patients then received bills they had no reason to expect, and some of the unpaid balances were sent to third-party collection agencies.
The state cites four violations of Ohio’s Consumer Sales Practices Act: failing to inform consumers of their right to a cost estimate before service; balance billing patients for out-of-network charges left over after insurance paid; making false or misleading statements about cost; and requiring consumers to enter transactions on terms the company knew were substantially one-sided.
More than 20 consumers complained to the Attorney General’s office about transports that occurred between July 2024 and June 2026. “Patients being transferred between hospitals have enough to worry about without getting hit with unexpected bills weeks later,” Yost said. “Consumers deserve to know when a company is out of network and what costs they may face before services are provided.”1Ohio Attorney General. Yost Sues Ambulance Company Over Deceptive Billing
Ohio is seeking restitution for affected consumers, civil penalties, and an injunction to stop the practices. Superior had not responded publicly by the filing date, and a spokesperson was not available for comment, according to the Columbus Dispatch.2The Columbus Dispatch. Superior Air-Ground Ambulance Sued by Ohio Attorney General Dave Yost
The Billing Complaints Behind the Lawsuit
The pattern the state describes matches complaints Superior has drawn for years across multiple states. The Better Business Bureau flagged a “pattern of complaints” against the company, logging 143 over a three-year period. Fifty-two involved billing, most describing the same core problem: enormous bills because Superior was out of network, from patients who had no say in which ambulance company picked them up.3Better Business Bureau. Superior Ambulance Service Complaints
Individual cases show the scale. A Sheboygan, Wisconsin family was billed $10,540 for a 58-mile ground ambulance ride for their one-year-old son in October 2023, and still owed $6,921.66 after insurance. Superior’s base rate for the specialty care transport was $6,600, more than double what competing Wisconsin providers charged for comparable service.4FOX6 Milwaukee. Sheboygan Family Fights Astronomical Ambulance Bill A Metro Detroit family received a bill exceeding $8,000 for a 15-mile transport of their daughter, who had a mild case of RSV and was released shortly after arrival. The balance was later adjusted to zero after a local television station intervened, and Superior set up a dedicated hotline for Michigan billing disputes.5WDIV ClickOnDetroit. Here’s What Superior Ambulance Said About Massive Surprise Bills Hitting Metro Detroiters
Other BBB complaints describe $8,068 for a 14-mile transport and over $3,200 for a non-emergency ride of less than eight miles. Patients often said they were incapacitated or in critical condition and could not have chosen a provider. Superior’s standard response, according to the BBB, was that it is not in network, is not required to accept insurance-negotiated rates, and that patients should appeal to their insurers.6Better Business Bureau. Superior Ambulance Service Complaints
The Data Breach Class Action and $3.2 Million Settlement
A separate lawsuit dealt with a data breach, not billing. In May 2023, an unauthorized actor accessed Superior’s network and copied files with sensitive information on roughly 858,000 people. Depending on the individual, the data could include Social Security numbers, driver’s license numbers, financial account and payment card information, medical diagnoses, treatment records, and health insurance details.7HIPAA Journal. Superior Air-Ground Ambulance Service Data Breach Affects 858K Individuals
Kirkston Spann II filed a proposed class action, Spann v. Superior Air-Ground Ambulance Service, Inc. (Case No. 1:24-cv-04704), in the U.S. District Court for the Northern District of Illinois, alleging Superior failed to implement reasonable data security and violated HIPAA and the Federal Trade Commission Act.8Bloomberg Law. Ambulance Service Sued Over Data Breach Affecting 858,000 People The case settled for $3.2 million. Class members who filed valid claims by the March 31, 2025 deadline could receive up to $5,000 in reimbursement for documented out-of-pocket losses tied to the breach, a pro rata cash payment from the remaining fund, and two years of three-bureau credit monitoring.9Superior Ambulance Settlement. Settlement FAQ Judge Matthew F. Kennelly granted final approval on April 2, 2025.10Almeida Law Group. Federal Court Grants Final Approval to Superior Ambulance Data Breach Settlement The claims deadline has passed, so no new claims can be filed.
The 2022 Medicare Billing Settlement
In March 2022, Superior agreed to pay $287,880.72 to settle allegations by the U.S. Department of Health and Human Services Office of Inspector General that it violated the Civil Monetary Penalties Law. The government alleged that Superior submitted claims to Medicare Part B for ambulance transportation to and from skilled nursing facilities when those services were already covered under Medicare Part A’s consolidated billing payment.11HHS Office of Inspector General. Superior Air-Ground Ambulance Service Agreed to Pay $287,000
Why Ground Ambulance Bills Keep Slipping Through
Part of what makes the Ohio case possible is a gap in federal law. The No Surprises Act, in effect since 2022, protects patients from balance billing by out-of-network providers in many situations, including air ambulance services. It explicitly excludes ground ambulance services.12The Ohio State University. Stopping Surprise Ambulance Bills: A Tough Policy Puzzle A congressional advisory committee issued reform recommendations in August 2024, but as of 2026 Congress has not acted on them.13CMS. Advisory Committee on Ground Ambulance and Patient Billing
States have moved to fill the gap unevenly. Ohio enacted balance billing protections for ground ambulance services, but they apply only to fully insured health plans, not the self-funded employer plans that cover most American workers.14Fisher-Titus Medical Center. No Surprise Billing Indiana’s House Bill 1385, effective January 1, 2025, caps insurer payments to out-of-network ambulance providers at the lesser of a locally established rate, 400% of the Medicare rate, or the provider’s billed charges, and treats that payment as payment in full. Superior’s spokesperson said the company supported the Indiana law, calling it “fair reimbursement” that keeps patients out of the middle.15WTHR Indianapolis. Governor Holcomb Signs Law to Protect Hoosiers From Surprise Ambulance Bills As of 2026, twenty-two states have enacted some form of ground ambulance billing protection.16The Commonwealth Fund. Consumers Still Face Surprise Bills From Ground Ambulances — States Are Trying to Protect Them
If you received a Superior Ambulance bill in Ohio and believe you were not told the company was out of network, you can file a complaint with the Ohio Attorney General’s office; the state is seeking restitution as part of the pending case.