On June 26, 2020, the Texas Supreme Court ruled in a 7-2 decision that insurers may reimburse air ambulance providers for the “fair and reasonable medical expenses” incurred in providing such service. Air ambulance providers argued that the federal Airline Deregulation Act (ADA) preempted any state fee reimbursement schedule. The Court held that the ADA does not preempt state fee regulation and the ADA does not require carriers to pay the full billed amount. The Court remanded the case and considering other similar cases that are still ongoing, this battle is likely not over yet.