By Alex Gault
Watertown Daily Times
WATERTOWN, N.Y. — Bruce G. Wright, a paramedic and the president and CEO of Guilfoyle Ambulance Service in Watertown, has been asking federal and state lawmakers to do something about the low reimbursement rates paid to EMS providers for Medicare and Medicaid patients for more than 20 years. Now, one of the federal lawmakers that represents Watertown is backing a bipartisan bill that would fix the Medicare rates.
The RESCUE Act, long name Reimbursing Emergency Services for Critical Urgent Events, would require that the federal agency that oversees Medicare update its fee schedule once every three years to keep rates commensurate with the costs of caring for a patient. It’s backed by both Republican and Democratic lawmakers in the House, including Rep. Claudia L. Tenney, R- Cleveland.
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“I’m happy this is on the radar, that our representative has brought this to Congress and that they’re thinking about this critical service,” Wright said.
Since 2002, Guilfoyle and every other ambulance operator in the country has been working off the same Medicare reimbursement rate structure. A report done in 2024 by the RAND Corp. for the federal Center for Medicare and Medicaid Services found that on average, ambulance agencies are paid over $1,500 less than the costs they incur per transport. That’s true for privately insured, Medicare, Medicaid and self-pay patients, but especially in rural areas a majority of patients who use ambulance services are covered by Medicare and Medicaid.
Wright and a coalition of statewide advocates for EMS providers have been asking officials for years to update the funding formula, which relies on data last collected in 1998, nearly 30 years ago. And as Wright explained, the medical field and the economy have changed significantly since then.
“Obviously the cost of providing services has changed, it’s much higher,” he said. “Fuel and wages are a lot more costly now, and the costs of the medical technology we use have gone up as well. But also, across the country, the numbers show that EMS is being used a lot more to respond to many different types of emergencies.”
Wright said some of that is driven by the expansion of the 911 emergency telephone system; 911 wasn’t universally available across the entirety of the U.S. until the mid 2010s, and with the way emergency services work now, Guilfoyle and other EMS providers are called out a lot more frequently than they used to be.
Wright said he and the other EMS advocates continue to ask that state officials do their part to increase Medicaid reimbursement rates, which are not set by the federal government but instead by state Departments of Health. That issue, while similar to the federal one, is more complex as the state’s reimbursement rates rely on a more complex formula.
“It’s almost a one-size-fits-all thing federally, while with New York state it’s based on what county you’re in,” he said. “But the message is the same across the board; we are grossly under-reimbursed for the services that we provide.”
The RESCUE Act was introduced at the end of July. Congress is about to return to Washington, D.C., on Aug. 31 after the usual summer recess. The bill has been referred to the House committees on energy and commerce as well as the ways and means committee, with no clear timeline on when they will be considered in those committees or moved to the floor of the House.
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