Dear Representative (Senator) add name:
INSERT A BRIEF DESCRIPTION OF YOUR SERVICE
EMS Agencies have not received an increase in reimbursement for transporting individuals covered by Medical Assistance since 2004. The current rates for Advanced Life Support (ALS) and Basic Life Support (BLS) are $200 and $120 per trip respectively. These rates are over 200% BELOW Medicare and commercial insurance reimbursements and do not come close to covering the real cost of transporting Medicaid patients.
Legislative efforts have been underway for many years aimed at enhancing the payment process between EMS providers and commercial insurers. These initiatives have been largely driven by the recognition that the current EMS network is severely strained financially, primarily as a result of woefully inadequate rate reimbursement for Medicaid patients. EMS Agencies truly are the first line of contact when it comes to the emergency medical care Pennsylvanian’s receive and it is critical these organizations are adequately and appropriately reimbursed for the life-saving services they provide.
In 2004, EMS Medical Assistance reimbursement rates were increased for the first time in 25 years. Since 2004, the cost to provide EMS service has increased over 60% and the number of ambulance transports to Medical Assistance beneficiaries has increased. Given the time that has elapsed since the last increase and the ever growing population covered by Medical Assistance, it is imperative that the General Assembly increase reimbursement rates for Medical Assistance ambulance transportation from both fee-for-service AND the Managed Care Organizations. We would respectfully request you consider increasing the rates in the 2016-2017 budget by 50%, which we understand would have a fiscal impact of approximately $16 million. We also ask that you send a letter to leadership in support of this budget item.
The EMS community is facing tremendous losses due to the inadequate reimbursement structure and this is fostering a public safety crisis in Pennsylvania. This situation is already resulting in the need to reduce staffing levels at many EMS agencies. This alarming trend, whichis the only method of survival other than completely closing, is reducing timely access to care for all of the residents and visitors in the Commonwealth and will result in higher morbidity and mortality. One national ambulance company, TransCare, and one international ambulance company, Falck Inc., closed their doors in Pennsylvania specifically due to the reimbursement environment. We are committed to carrying on our mission of serving Pennsylvanians when they are the most vulnerable and in their time of greatest need but in order to achieve that it will require your help and support.
Thank you for your consideration of this request. Should you have any questions, please don’t hesitate to contact INSERT YOUR CONTACT INFORMATION.
Sincerely,