Senator Charles Schumer Introduces Medicare Ambulance Access Act

Bill Would Extend Existing Medicare Reimbursement Rates for Ambulance Transport Until 2019

On July 31 Senator Charles Schumer (D-NY) introduced the Medicare Ambulance Access Act (S. 1403), which would extend the current reimbursement rates paid by Medicare for ambulance transport services for five years until January 1, 2019. The current rates are set to expire at the end of the year, which would mean a dramatic reduction in the payment that ambulance service providers receive for transporting patients.

In the Balanced Budget Act of 1997, Congress established that beginning in 2002 the way that Medicare reimbursement rates were calculated for ambulance transport (among other services) would change. This would have resulted in a significant reduction in reimbursement rates to a level well below the average cost of providing service. To prevent this, Congress established “bonus” payments designed to close the gap between statutory payment levels and the actual cost of providing service. Even with the bonus payments, a 2007 Government Accountability Office report found that rates still fall short, particularly in rural areas where providers typically have to travel longer distances to transport patients to hospitals.

Despite efforts to develop a long-term fix to the payment shortfall problem, Congress has made an annual practice of renewing the bonus payments for another year at the last minute. Although S. 1403 would not be a permanent solution, extending the payments for five years would at least give providers more certainty about Medicare reimbursement in the near- to medium-term.

In addition to S. 1403, the tax-writing committees in the House and Senate are in the process of developing broad “tax reform” legislation that is intended to simplify the tax code. It is anticipated that an effort will be made to overhaul the way that Medicare reimbursement payments are calculated as part of tax reform, although what form that will take and whether or not it will be successful are still very much up in the air.

The NVFC will continue to monitor this issue and provide Section members with timely updates as new information becomes available. We will also work to ensure that reimbursement rates for volunteer ambulance providers are sufficient for those providers who charge for transport services.