To prevent astronomical bills for patients who were transported by air ambulances, Rep. Tina Pickett (Bradford/Sullivan/Susquehanna) worked with her colleagues during 2018-19 state budget negotiations to ensure an increase in mileage and Medicaid reimbursement rates for air ambulance services.
“Over the past couple of years, several local residents who have been transported by air ambulances for medical emergencies have been billed, sometimes thousands of dollars,” said Pickett, who chairs the House Insurance Committee and has been working with industry leaders on the issue throughout the session. “By all means, these air ambulances provide a necessary form of transportation and urgent health care to trauma centers and hospitals when minutes literally matter. We want to ensure their availability by updating their reimbursement rates.”
As part of the Fiscal Code portion of the budget package, House Bill 699, Pickett negotiated an increase to a maximum Medicaid reimbursement of $3,325, and for air mileage, no less than $22.45 per patient load mile. Before this legislation, the maximum was about $200 per transport. That rate is unsustainable, considering the cost of fuel for one trip is about $450.
Pickett noted that constituents who have received bills upward of $30,000 and more have reached out to her. In some cases, private insurance denied the claim or only paid a partial claim, leaving consumers obligated to pay the remaining balance.
“I am hopeful that increasing the Medicaid reimbursement will help these companies offset their expenses and not spread the burden out to other consumers,” Pickett noted. “I also hope that increasing the state reimbursement will also lead to other insurance companies picking up more of the tab. Air ambulances are literally life-saving services, especially in our rural part of the state.”
The Fiscal Code also included Medicaid reimbursement increases for traditional ambulance services, both operating as volunteer and for-profit. An additional $4 million in state funds and approximately $8 million in federal matching funds will be used to support Medicaid reimbursement increases. Specifically, reimbursements for Advanced Life Support (ALS) services would be increased from $200 to not less than $300, and Basic Life Support (BLS) services will be increased from $120 to $180. The rate increase will be effective Jan. 1, 2019.
This is the first increase in Medicaid reimbursement for the state’s ambulance companies since 2004. Current rates are more than 200 percent below reimbursements provided by Medicare and commercial insurance, which has made it increasingly difficult for ambulance companies across the state to keep operating.