– With emergency medical services (EMS) agencies across Pennsylvania, and especially those in rural communities, struggling to keep their doors open, Rep. Martin Causer (R-Cameron/McKean/Potter) has introduced legislation that would boost Medicaid reimbursement rates for the life-saving services they provide.
“Prompt response by an ambulance is the difference between life and death for many patients, and we have a responsibility to do all we can to ensure those services remain available to people across the Commonwealth,” Causer said. “Too many EMS agencies, especially in rural communities, are really struggling to keep their doors open, in part due to low reimbursement rates from the state that come nowhere near covering actual costs. My bill aims to change that.”
EMS providers have received only two increases in reimbursement for transporting individuals covered by Medicaid in the last two decades with the last increase taking place in 2018, again based on legislation Causer introduced. The current rates for Advanced Life Support (ALS) and Basic Life Support (BLS) services are $300 and $180 per trip, respectively. These rates are significantly below Medicare and commercial insurance reimbursements.
House Bill 2434
proposes to increase the rates for ALS to $400 and BLS to $325, representing a reimbursement of approximately 80% of the current base Medicare rate in Pennsylvania, plus a reflection of the change in the Consumer Price Index (CPI) since 2018. The bill would also offer an added premium for rural providers, similar to that offered through Medicare, to recognize the added costs those services face.
Finally, the bill would require that EMS agencies be paid for all loaded miles at a rate of $4 per mile. Currently, Medicaid reimburses $2 per loaded mile, but only after the first 20 miles. Future reimbursement rates for services and mileage would increase when Medicare rates increase based on changes to the CPI to keep pace with the increased cost of providing this service.
“EMS providers truly are the first line of contact when it comes to the emergency medical care Pennsylvanians receive, and it is critical these organizations are properly reimbursed to ensure they are able to continue their mission of saving lives,” Causer said.
Causer has long been a leader in efforts to support the state’s EMS providers. He sponsored the legislation to increase Medicaid reimbursement rates in 2018. He has also supported laws to reimburse for treatment, even when transport does not take place, and for direct payment by insurance companies to ambulance service providers.