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03/28/2024 06:37 PM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20210&cosponId=36908
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House of Representatives
Session of 2021 - 2022 Regular Session

MEMORANDUM

Posted: February 23, 2022 11:10 AM
From: Representative Martin T. Causer
To: All House members
Subject: Cosponsor - Medicaid Reimbursement Increase for Emergency Medical Services
 
In the near future, I will be introducing legislation to require an increase in the reimbursement rates under Medicaid for the provision of emergency medical services.

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. The current rates for Advanced Life Support (ALS) and Basic Life Support (BLS) are $300 and $180 per trip, respectively. These rates are significantly 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 for EMS providers. 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 providers truly are the first line of contact when it comes to the emergency medical care Pennsylvanians receive and it is critical these organizations are properly reimbursed for the life-saving services they provide.

I am proposing to increase the rates for ALS to $400 and BLS to $325, representing a reimbursement of approximately 80% of the current base Medicare rate in Pennsylvania, plus a reflection of the change in the CPI since 2018. In addition, I am proposing to enact a “super rural” provision as currently designated by Medicare to provide an additional modest increase for services provided in the most rural parts of our state.

This legislation will also require that EMS services be paid for all loaded miles at a rate of $4 per mile. Future reimbursement rates for services and mileage would increase when Medicare rates increase based on changes to the CPI to keep pace with the increased cost of providing this service. Given the time that has elapsed with only two increases in over two decades and the ever-growing population of Pennsylvanians covered by Medicaid, it is beyond time the General Assembly increase EMS Medicaid reimbursement rates for ALS and BLS transport.

Please consider joining me in sponsoring this important initiative to support our EMS providers and our constituents who rely on them.



Introduced as HB2434