By: Charles Romans
Carter County Times
A new bill introduced to the Kentucky State House and Senate is aimed at modernizing the reimbursement rates for emergency ambulance services. House Bill 447 addresses the fact that reimbursement rates have not kept pace with operating costs, a fact that proponents of the bill say is a contributing factor for over 91 percent of Kentucky counties operating in ‘ambulance deserts’. An ‘ambulance desert’ describes a situation where county residents are 25 minutes away from a timely EMS response.
Carter County EMS Director Tim Woods said he endorsed the bill, but said he did have initial concerns that it would raise insurance premiums. Woods said that he was told by the Kentucky Ambulance Providers Association (KAPA) that a similar bill had passed in 27 other states, and premiums had only increased by around a dollar over the course of a year. Once that concern was addressed, Woods said he signed on to endorse the bill.
Woods said that if the bill passes, Carter County EMS could see an increase in revenue of nearly $200,000 based upon the number of calls made the previous year.
“If it passes, it’s supposed to increase the reimbursement from the insurance,” Woods said.
This increased reimbursement will help to offset the expenses ground based ambulances incur during operation, he said. This would be in tandem, he said, with another bill that is seeking to increase Medicare and Medicaid reimbursements.
“The biggest thing we need to do in Kentucky is to make EMS an essential service,” Woods said. “But it’s not. You aren’t required by law to have an ambulance service in the county.”
This becomes a problem when a private ambulance service ceases operations and pulls out of the county, as recently happened in Lewis County. After that withdrawal, the county was forced to establish an ambulance service.
“It’s beyond me that no one really considered us an essential service,” Woods said.
Reimbursement is an ongoing issue, Woods said, that can be further complicated by things such as government shutdowns. And while waiting for reimbursement, of course, ambulance services have to foot the bill for expenses. This can be a serious budgetary inconvenience or outright devastating to the provider. This becomes even more challenging when a provider pays into their funding, and the government is slow in paying their part.
Woods said that ideally if bills such as House Bill 447 are passed it will improve the reimbursement process. Not all services are covered by insurance, and of those covered the full amount might not be paid. The Kentucky Emergency Response Alliance stated that Insurance companies reimburse less than half of what ambulance services bill, and in some counties they reimburse as little as ten percent of what is billed.
“We are managing,” Woods said. “But I feel sorry for some of these counties that only have one, maybe two ambulances to cover the entire county. Everyone needs more money. But those counties really need it.”
Currently House Bill 447 is in the Banking and Insurance Committee, and when it leaves that committee the bill will progress to the State Senate to be voted on.
Contact the writer at charles@cartercountytimes.com
