With many ambulance companies struggling to keep their doors open, the state House on Monday approved legislation to increase the Medicaid reimbursement for emergency medical services.
“The current reimbursement rates come nowhere near covering actual costs. In fact, they are more than 200 percent below reimbursements provided by Medicare and commercial insurance,” said sponsored Rep. Martin Causer (R-Turtlepoint). “Ambulance services that care for a high volume of Medicaid patients cannot continue to provide these life-saving services without additional support.”
House Bill 699 would increase reimbursements for Advanced Life Support (ALS) services from $200 to not less than $300, and for Basic Life Support (BLS) services from $120 to $180. The rates were last adjusted in 2004.
Causer noted the Medicaid reimbursement rate was one of several challenges identified by the Rural EMS Task Force he formed with ambulance officials, health care providers and other impacted groups across the three-county area.
“Access to emergency medical services can mean the difference between life and death for many patients, and that is especially true in rural areas where many people live far away from local hospitals,” Causer said. “This is a major step forward in addressing the financial challenges facing our ambulance services.”
Bert Sorg, manager of the St. Marys Ambulance Service, lauded Causer for standing up for local ambulance services, saying that an increase in reimbursement is something Sorg and ambulance services across the state have been asking for for some time.
“The Senate needs to pass this as soon as possible to help keep emergency medical services in Pennsylvania alive,” Sorg said. “Hopefully it will pass the governor’s desk.”
Sorg said the ambulance service ended 2017 with more calls than previous years but with less revenue, he said the ambulance company is “just making it.”
The issue with the reimbursements, according to Sorg, is that ambulances haven’t seen an increase in Medical Assistance rates in 12 years.
Donald Logan, manager of Bennett’s Valley Ambulance Service, echoed that sentiment, explaining that an average bill for service for a patient with Medical Assistance runs between $700-$800 and the reimbursement is a flat rate of $120. Medicare reimbursements average about 50 percent of the bill.
“We get very little,” said Logan, who added that the ambulance company is having to turn outward more often for grant funding, donations and community support, especially as the population served by Medical Assistance or who lack any insurance at all continues to grow. “Everyone is seeing the cutbacks in memberships and reimbursements.”
“Any increase would be good,” Logan added.
The state House has also approved legislation to address another financial concern raised by the group. House Bill 1013 would allow for reimbursement when treatment is provided but transport does not take place. The bill sets the following conditions for reimbursement: The BLS or ALS unit must be dispatched by a county 911 center, and the EMS provider must have rendered care even though the transport was declined.
Both bills are now awaiting consideration in the Senate.