By Donna Goodison
The Boston Herald
Fresh off a second losing legislative bid, American Medical Response is sounding its siren about Blue Cross Blue Shield of Massachusetts.
The nation’s largest private ambulance service said the health plan’s practice of reimbursing patients instead of the company for emergency ambulance runs has left it out of millions of dollars and forced layoffs.
AMR claims that Blue Cross members have failed to pay it $3 million for ambulance transportation since Blue Cross stopped making direct payments to the company in 2010. “The ambulance business: First to respond, last to get paid,” said Brendan McNiff, general manager for the Colorado-based AMR. “I shouldn’t have to take people to court to pay for stuff their insurance companies paid them for.”
AMR serves 15 communities, providing more than 400 emergency and nonemergency transports per day. The company said it’s exiting the Worcester, Milford and Newburyport-area markets as a result of the payment problems, and the retrenchment will result in 127 layoffs.
AMR has refused to sign a contract to be a Blue Cross network provider.
Ambulance companies in Blue Cross’ network get paid directly by the insurer, but AMR has refused to sign a contract. McNiff said it “doesn’t pay for the cost of service we provide.”
Blue Cross counters the issue comes down to health care affordability.
“In recent years, out-of-network ambulance companies have charged our customers prices that are 300 (percent) to 500 percent more than what Medicare pays for the same exact service,” Blue Cross spokeswoman Sharon Torgerson said.
Blue Cross estimates that’s costing its employer customers and members “tens of millions of dollars” each year.
“This makes no sense at a time when everyone agrees we should be doing everything we can to make health care more affordable,” Torgerson said. “In an effort to rein in these runaway costs, we took aggressive action two years ago that introduced an initiative to pay our customers directly for ambulance services for ambulance companies that refused to contract with us.”
Gov. Deval Patrick returned a proposed ambulance bill to the Legislature last month that would have required insurers to pay ambulance providers directly for emergency service. A coalition of business groups opposed the bill, which has failed twice.
Republished with permission from the Boston Herald