HARRISBURG – The House Veterans Affairs and Emergency Preparedness Committee on Wednesday approved legislation that would boost Medicaid reimbursement rates for emergency medical services (EMS) agencies, said Rep. Martin Causer (R-Cameron/McKean/Potter), prime sponsor of the measure.
“It comes down to this: Our EMS agencies are really struggling to keep running, especially in rural areas,” Causer said. “My bill would provide much-needed increases in reimbursements to help ensure they have enough money to continue their life-saving mission.
“In other words, if we want an ambulance to answer our call in an emergency, we need to answer their call and provide the funding and support they need to keep going,” he added.
Watch Rep. Causer’s remarks to members of the committee prior to the vote: https://s3.us-east-2.amazonaws.com/pagopvideo/895566349.mp4
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.
The bill now goes to the full House for consideration.
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.