By EMS1 Staff
VIRGINIA BEACH, Va. — An ambulance company ended its services this weekend after not receiving Medicare reimbursements.
Mid-Atlantic Regional Ambulance owner Scott Johnson said the agency could no longer afford to remain open after waiting on hundreds of thousands of dollars from Medicare for transporting dialysis patients.
The service will refer its 55 dialysis patients to other ambulance companies; 50 full-time and part-time employees are now out of a job.
A program that aims to alleviate Medicaid reimbursement issues will require ambulances to obtain prior authorization for calls covered under Medicaid. The program is being tested across eight states, which Medicare said is designed to curb fraud and reduce overall costs.
Under the program, Medicare requires that a patient’s doctor must complete a form that certifies the need for transport and medical treatment, regardless of whether the patient has previously transported. Medicare evaluates letters and looks into the patient’s medical records before approving the transport. If denied, the patient needs to pay out-of-pocket or consider using Medicaid as an alternative to pick up the cost.
Medicare reported that ambulance transport payments jumped 130 percent, $4.5 billion dollars, from 2002 to 2011.
Local ambulance companies told 10 On Your Side less than 10 percent of their regular dialysis patients were getting approved. Medicare data showed only 35 percent of claims were being approved.
Johnson said employees and vendors will be compensated for everything they are legally owed.