Friday, April 28, 2017

The Power of EMS in Politics- Again!

EMS “News”

Check the “News” section of our website at and you’ll find that we have shared a few articles, this week, detailing important legislative initiatives both nationally and also in our home State of Pennsylvania.

The Power of EMS in Politics- Again!In most areas across the United States, EMS is stressed and much of the stress has to do with reimbursement policy at the government level that fails to recognize what it takes to keep EMS going financially.
The largest ambulance service in Lancaster County, Pennsylvania, nonprofit Lancaster EMS, wrote off $1.6 million in unpaid bills in 2016.*
Stale reimbursement rates, Obamacare, skyrocketing insurance deductibles and the compounding effects of the opioid crisis has all of EMS sharpening the pencil on our budgets to find ways to trim costs and be creative about developing new revenue streams.
Ambulance companies are facing financial difficulty because the federal Medicaid reimbursement rates have not increased since 2004. For Lancaster EMS, an average call costs the company about $350; in return, it gets reimbursed $200 by Medicaid.*
The American Ambulance Association, just this week, sent out an Advocacy Member Advisory written by the AAA’s President urging everyone to contact their elected members of Congress to advocate for the passage of S. 967, the “Medicare Ambulance Access, Fraud Prevention and Reform Act.” To say this is important legislation for EMS in the United States is an understatement for sure.
Due to AAA advocacy efforts, permanent ambulance relief (Medicare ambulance add-on payments) legislation was introduced by Senators Stabenow, Roberts, Schumer, Collins, and Leahy.**


Back in 2015, when the Presidential campaign was really heating up and the field of 15 or so GOP candidates were all beating each other up and calling each other names, we wrote our first “Power of EMS in Politics” blog.

Here we are again.

Now, we have a new President. The legislative and executive branches of government are controlled by the same party and everyone is working feverishly to “repeal and replace” Obamacare. All that’s well and good but will it make a difference for EMS? We certainly hope so because we need a “difference!”

Grass Roots

Then, as now, we made this assertion and we still believe it to be true.

It’s at the grass roots level that we believe the Fire/EMS community can make a big difference by constantly championing causes to make our needs known to the politicians that comprise our elected government. It all flows up hill and overall policy changes that affect what we do begin by engaging those officials.

We give props to the American Ambulance Association for being the voice of EMS in America at the national level. But for the AAA to do their job, it requires that those of us on the local level begin the process of talking to our local elected officials at all levels so the larger message is supported at the higher levels.

Thus the AAA’s call to action this week.

In Pennsylvania, a few weeks ago, the Ambulance Association of Pennsylvania (AAP) participated in a legislative hearing on the status of EMS in Pennsylvania. AAP sat at the table with bureaucrats, the insurance payers representatives and lawmakers to present testimony advocating for change in how the Commonwealth directs payments to EMS.

Such conversations are happening in State capitols and forums all across our great nation.

It’s important for us to be heard and get the message out because we can’t keep doing what we’re doing if they keep squeezing us in the pocketbook.


It’s all about having conversations. It’s all about building relationships and providing education about who we are and what we do in EMS.

All elected officials must be elected to be an official. This means that those officials are interested in you if for nothing else than to win over your vote in the next election.

This is especially true at the local level where decisions made in local government many times have a powerful direct effect on your day-to-day operations. Consider such things as approving coverage area, making decisions about what agency operates where and when. Local officials many times control the very dispatching agency that provides you with your daily workload but you control whether or not they get the chance to make those decisions.

So get out there and tell them where you stand. Don’t be afraid to express your needs as a provider and the needs of your organization as a whole.

You have power…

Remember, every elected official must be continually reminded that EMS doesn’t just happen and what they do affects what we do each and every day…both regulatory and most importantly, by controlling the dollars that support what we can and cannot do.
Please contact your Senators to voice your support for S. 967. AAA makes it easy to connect with your legislators through our online advocacy tool—please use it today to quickly send messages expressing the importance of the legislation to your ambulance service and the communities you serve.**
The Ambulance Billing Services blog is brought to you as an educational tool by Enhanced Management Services, Inc. Enhanced Management Services, Inc. is an all-EMS third-party billing contractor serving Fire/EMS agencies across the United States. To learn more about who we are and what we do, please visit our website at and click on the “Get Started” button on any landing page.

*Excerpts from "Critical Times Ahead" by Susan Baldridge, Lancaster Online (April 28, 2017)
**Mark Postma, President, American Ambulance Association (April 28, 2017)

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