NCPA - National Center for Policy Analysis

Emergency Services Raise Ambulance Fees

December 30, 2010

Ambulance providers nationwide are coping with rising costs, decreased support from local government, low Medicare reimbursement rates and a jump in the number of uninsured Americans, says Stephen Williamson, president of the American Ambulance Association.

A 2007 report by the Government Accountability Office showed providers were paid a Medicare reimbursement rate 6 percent below cost, and the gap widened to 17 percent in remote areas. Williamson says the disparity has grown since then.  In the past, providers could rely on subsidies from local government, but those resources have dwindled during the economic downturn, Williamson says.

Steve Weigand, director of servicing for the International Association of EMTs and Paramedics, says the number of uninsured people receiving ambulance transport has swelled during the past 18 to 24 months.

Among ambulance providers to recently seek increases:

  • Colorado Springs: American Medical Response of Colorado, a private ambulance company, will increase rates by nearly 6 percent Saturday, says Douglas Moore, a spokesman for Emergency Medical Services Corp., AMR's parent company.
  • Los Angeles: The city's fire department increased its ambulance prices by nearly 37 percent to $974 for basic life support services in July, the second hike in two years, says David Frelinger, a battalion chief in the emergency medical services section

Even when ambulance providers increase their rates, they often get only a fraction of the full payment, says Cathy Carter, president of Medical Claim-Aid in Denton, Md., which provides billing and collection services for ambulance providers in Maryland, West Virginia and Virginia.  Medicare and Medicaid pay a fixed amount, based on set rates that are below the actual cost of ambulance transports, she says.

Private insurers in some cases have stopped reimbursing ambulance providers and send payment directly to the patient, she says. The problem with that, Carter says, is that the person often pockets the money.

Source:  Greg Latshaw, "Ambulance Fees Increasing Across USA," USA Today, December 29, 2010

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