Friday, June 8, 2018

Legislative Initiatives Poised to Benefit EMS in Three States

PA, NY and MD

State lawmakers in Pennsylvania, New York and Maryland have been working on new legislation that has the potential to drastically change the EMS reimbursement landscape.

Legislative Initiatives Poised to Benefit EMS in Three States

This year has seen a flurry of activity in the chambers of government across these States as fire and EMS advocates are sounding the alarm regarding stagnant reimbursement rates that are failing to keep pace with the growing costs to provide EMS services.

While Pennsylvania and New York lawmakers are still considering future passage of their initiatives, their counterparts in Maryland have successfully pushed legislation that has now been signed into law by that States governor.


Maryland Senate Bill 682

On May 15th, Governor Larry Hogan signed into law Senate Bill 682. The new law will be enacted officially on July 1st.

This new law charges the Maryland Institute of Emergency Medical Services Systems (MIEMMS) and the Maryland Health Insurance Committee to initiate a 6-month study for report back to the State Legislature to devise a plan that will require commercial insurance payers and Maryland Medical Assistance to pay for the following…
  • Mobile Integrated Health Care (MIHC)
  • Treatment of a patient on the scene but with no transport required
  • Transport of a patient to an alternative location that is not a hospital destination
The bill calls for a comprehensive plan to be submitted as part of the report including a plan for how such reimbursement will be obtained from the Medicare program, as well.

Under consideration, as part of the study, is for the Maryland Medical Assistance program to initiate a rule change so Medicaid payments can begin on January 1st. The Medicare issue, while tied up in Federal initiatives may be tackled under a waiver program set to take effect also on January 1, 2019 which includes a “total cost of care” initiative.


Pennsylvania Senate Bill 1013 / House Bill 699

Legislation spearheaded in Pennsylvania by a State lawmaker with direct EMS ties has been passed just this week in the Pennsylvania Senate. Senate Bill 1013 was approved by the upper chamber, putting into motion a series of events that will require Pennsylvania Medicaid and commercial insurers to reimburse EMS agencies when emergency treatment is provided at the scene but transportation is not required.

State Representative Martin Causer of the 67th Legislative District encompassing Potter and McKean Counties in the Bradford and Coudersport areas of the State is leading the rally complete with House Bill 699. Causer, a former EMS provider himself, has been a champion for this legislation. This week he organized a rally of EMS representatives in Harrisburg which later resulted in the passage of SB 1013.

HB 699 takes another pathway to improving reimbursements for Pennsylvania’s ambulance industry. The bill proposes a 50% increase in Pennsylvania Medicaid reimbursements, which would be only the second such fee update since Medicaid began reimbursing for ambulance transportation in Pennsylvania.

As the overall discussion of the thinning ranks of fire and EMS personnel in Pennsylvania gains traction, these initiatives at the State government level will help ease some of the concerns for EMS administrators across the Commonwealth.


New York S0363 / A7717b

With a heavy push by the Fireman’s Association of the State of New York, the New York State Association of Fire Chiefs and the County Fire Coordinators Association of the State of New York, two bills have been introduced that are mirrored in nature. In the Senate S0363 and in the Assembly A7717b were introduced earlier this year with focus on allowing Fire Departments in that State to recover the costs of EMS services.

The move has gained traction as championed by several North Country lawmakers who growingly have become concerned regarding fire departments in that geographic corner of New York expressing concern over growing budget shortfalls when providing ambulance services.

New York State has always had a moratorium in place prohibiting recovering reimbursement for EMS services by fire departments. For perspective, consider that of the 1,025 ambulance services in New York State, 468 of them are fire-department based accounting for 300,000 calls for service each year.*

The legislation has gained considerable headway over the past several weeks with the Senate moving S0363 into both the Local Government and Finance Committees while the State Assembly has Advanced A7717b through to their Local Government committee.


Every Penny Counts

We all know that every penny counts. Lawmakers are faced with the pressure of passing initiatives that will support vital emergency services while at the same time balancing a tight revenue stream that does not inordinately raise taxes for their constituents.

We will continue to follow these important pieces of legislation as they advance in these States. Certainly, there will potentially be other State lawmakers across the nation who will look to their counterparts for the overall outcome.

*The article, ”Bill would allow fire departments to recover costs of EMS services” published by The Legislative Gazette on 5/22/2018 is the source for New York State ambulance service statistics reported above.

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