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House of Representatives
Session of 2017 - 2018 Regular Session


Posted: January 4, 2017 02:04 PM
From: Representative Martin T. Causer
To: All House members
Subject: Medicaid Reimbursement Increase for Emergency Medical Services
In the near future, I will be introducing legislation to require an increase in the reimbursement rate under Medicaid for the provision of emergency medical services.

EMS providers have not received an increase in reimbursement for transporting individuals covered by Medicaid 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 providers truly are the first line of contact when it comes to the emergency medical care Pennsylvanians receive and it is critical these organization are properly reimbursed for the life-saving services they provide.

I am proposing increasing the rates for the 2017-2018 budget by 50%, which would have a fiscal impact of approximately $16 million. In 2004, EMS Medicaid reimbursement rates were increased for the first time in 25 years. Given the time that has elapsed since the last increase and the ever growing population of Pennsylvanians coved 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 EMS initiative.

Introduced as HB699