With many emergency medical services (EMS) agencies struggling to keep their doors open, the General Assembly has approved an additional $50 million in funding for increased Medicaid reimbursement rates, said Rep. Martin Causer (R-Cameron/McKean/Potter), lead sponsor of the initiative.
“Lives are on the line here,” Causer said. “Especially in rural areas like the ones I represent, where many people live far from a hospital, prompt response by an ambulance is the difference between life and death.
“Yet, it is our rural EMS agencies that are struggling the most with low reimbursement rates that come nowhere near covering their costs. The changes we’re advancing as part of the state budget will go a long way toward helping these providers continue their lifesaving work,” he added.
The plan would increase reimbursement rates for both Advanced Life Support (ALS) and Basic Life Support (BLS) services to $400 and $325 per trip, respectively. The change would represent 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.
Additionally, the measure would increase from $2 to $4 the mileage rate paid to EMS agencies for all loaded miles after the first 20 miles.
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.
“If we expect our emergency medical services providers to respond when we call 9-1-1, we need to do our part to support them,” Causer said. “This is a major step forward toward that goal, but there is more to do. I’ve never met people more dedicated to their work than our EMS providers, but their costs are rising and they cannot continue their critical mission without the money to pay for equipment, supplies, personnel and other operating costs.”
Causer has long been a leader in efforts to support the state’s EMS providers. In addition to sponsoring legislation to increase Medicaid reimbursement rates in 2018 and again this year, 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.
The higher reimbursement rates will take effect in January 2023.