NY EMS officials speak out on proposed cuts in Medicaid payments
The proposal would eliminate Medicaid payments for low-income and elderly patients insured by both Medicare and Medicaid
By Olivia Belanger
Watertown Daily Times
WATERTOWN, N.Y. — Even with ambulance company budgets razor-thin across the state, an amendment in Governor Andrew M. Cuomo’s proposed 2019 budget would require further cuts in services.
As part of the revisions to the Health and Mental Hygiene bill (S.1507, A.2007), the proposal would eliminate Medicaid payments for low-income and elderly patients insured by both Medicare and Medicaid — a decision that could cost all ambulance companies statewide an estimated total of $14 million per year.
Additionally, a 2017 New York State Department of Health report showed ambulance providers are substantially short-changed by Medicaid and recommended rate increases of $31.4 million.
However, the reimbursement rates are still under the true costs of providing service, taking a toll on both not-for-profit and commercial ambulance services.
From a regional standpoint, about 60 percent of patients have Medicaid, Medicare or both.
Ann M. Smith, EMS program director for the North Country Regional EMS Agency, said if the amendment passes, it will make everything twice as difficult.
“It would have a devastating effect on the ability for local residents to get an ambulance because we already have scarce service. It will become scarcer,” Ms. Smith said.
Bruce G. Wright, president and CEO of Guilfoyle Ambulance Services, said if approved, the agency would be facing a loss of six figures.
“We would have to cut services,” Mr. Wright said. “Potentially, we would look at taking a staffed ambulance off the road in our daily rotations ... that would be the first obvious place to look at.”
As a for-profit, private organization, Guilfoyle has a fully paid staff. Mr. Wright said he has 90 people on his payroll and nine operating ambulances.
Mark A. Deavers, director of operations for Gouverneur Rescue Squad, said the loss in funding will have to come out of the payroll budget.
“It’s an annual loss of somewhere between $38,000 and $50,000,” Mr. Deavers said. “Unfortunately, the only thing that would be available to cut is staffing, so less ambulances on the road.”
Mr. Deavers said he has 17 people on his payroll, with four operating ambulances.
Scott Lennox, director of operations for the Town of Watertown Ambulance Service, said his squad would be facing a $15,000 to $20,000 loss in annual income.
He said he has 18 people on his payroll and two operating ambulances. The loss would likely be taken out of equipment, Mr. Lennox said, but he is hopeful the amendment won’t be approved.
Several local squads — including Guilfoyle, Gouverneur and Watertown — are pushing back on the bill by speaking with local and state lawmakers to express their concerns.
“We met with Senator Patty Ritchie’s office, but some of the other squads have met with other legislators,” Mr. Lennox said. “We are just trying to get the ball rolling and get them behind us, and at this point they are.”
Mr. Wright said he, and other ambulance squads, have yet to receive an answer on the reasoning behind the proposed amendment.
Gov. Cuomo’s office was not available for comment on Tuesday.
Though approval of the amendment would negatively affect the ambulance squads, the bigger loss is for the community, according to Mr. Deavers.
“The only people actually hurt by this are the citizens and the patients,” Mr. Deavers said. “This is going to have devastating effects to the availability of ambulance services across the state.”
Mr. Wright said the emergency medical services statewide are incredibly fragile as is, so cuts like this aren’t plausible.
“This would be completely devastating,” Mr. Wright said. “You’re talking about fewer ambulances on the roads and detrimental outcomes for sick and injured patients.”
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