By Chris Swingle
Rochester Democrat and Chronicle
Copyright 2007 Rochester Democrat and Chronicle
ROCHESTER, N.Y. — Ambulance services would receive 5 percent more in Medicare payments, while Medicare Advantage plans and durable medical equipment suppliers would receive less from Medicare, under a proposal announced Monday by U.S. Senator Charles Schumer.
Medicare funds health care for people age 65 and older and for people with certain disabilities, who account for 40 percent of all ambulance calls.
Medicare payments to private, nonprofit and volunteer ambulance providers are 6 percent below the actual cost of providing ambulance services, according to a May 2007 Government Accountability Office report.
The rates are adjusted annually for inflation and are scheduled to rise 2.7 percent in 2008.
Increasing the reimbursement rates further would help ambulance companies afford cutting-edge medical equipment such as global positioning system devices and respiratory equipment to speed or improve care, said Schumer, D-N.Y. The senator held a news conference at Rural/Metro Medical Services’ fleet maintenance building on Scio Street about his bill, called the Medicare Ambulance Payment Extension Act (S. 1310).
Monroe County ambulance services received nearly $6 million from Medicare in ground base rates in 2005, which doesn’t include per-mile fees or air transports. Nationwide that year, Medicare spent more than $4 billion for ground ambulance transports.
Medicare’s per-call payments in Monroe County range from $185 to $300 for basic life support calls, which include patients who have broken limbs or gastrointestinal distress, said Barry Palatas, general manager of Rural/Metro. Per-call payments for advanced life support under Medicare range from $222 to $600, depending on the nature of the call.
Medicaid, which covers low-income people, pays lower rates: $125 for a basic life support ambulance transport and $195 per advanced life support transport in Monroe County, said Palatas.
Medicaid patients account for 20 percent of ambulance calls.
Insurance companies pay 20 to 30 percent more than Medicare, said Palatas.
Palatas said GPS isn’t a big need within Rochester city limits but could be useful in the suburbs. Rural/Metro, which is a for-profit company, likely would use additional money for training and better pay for ambulance care providers and for high-tech equipment. The 12-lead EKG monitors in each of its 30 ambulances cost $25,000 to $30,000 apiece, and technology keeps evolving, he said.