Cuts to Medicaid loom for Texas ambulance companies

AUSTIN (KXAN) — Several ambulance services from across Texas are working to stave off a potential 10 percent cut to their Medicaid reimbursements. The Texas Health and Human Services Commission is planning to cut the amounts ambulance services can bill the government for ambulance rides for people on government assistance.

The Medicaid reimbursement cuts would mean taxpayers would get a break on the amounts the government spends on Medicaid payments nationwide.

The HHSC is looking to make cuts to a list of 11 different health care fields that are allowed to charge the government for services performed on people on Medicaid. The most vocal opposition to the planned cuts is coming from ambulance services that serve rural Texas counties.

“I will transport 911 patients in spite of these cuts. I will not continue to transport inner-facility transports to get these patients where they really need to go. This will be the detrimental cost to Medicaid clients because they will not be able to get where they need to go because ambulance services such as mine cannot take any more of those losses,” Booker EMS Chief Jonathan Sell told the commission at a hearing Tuesday.

Sell said his EMS agency, which services an area in the far reaches of the Texas Panhandle, currently loses $443 each time it drives a Medicaid patient in one of its ambulances. Since ambulance services can’t bill a private insurer, which traditionally covers the cost of a medical transport, providers like Sell’s are left to transport Medicaid patients and rely on the amount the government will reimburse for that ride.

Medicaid is currently reimbursing those ambulance ride charges at around 60 percent, many of the EMS company representatives testified Tuesday. Most of the EMS transport losses are being made up by taxpayers in the counties with the shortfalls.

Booker EMS, like many others who showed up at the HHSC hearing Tuesday, mainly provide ambulance rides for Medicaid patients in their rural counties, which means most of the rides in their ambulances won’t be fully paid for.

“So, how are we supposed to deal with a $1.14 million budget loss?” MedStar Mobile Healthcare attorney Kristofer Schleicher asked the commission. MedStar is the metro-Fort Worth EMS provider for 15 cities around Fort Worth.

Schleicher told the commission his company provided 17,955 EMS transports for Medicaid patients in 2016 and lost an average of $130.29 with each ambulance ride. MedStar charges $416 for each ambulance ride, a cost Schleicher said, “Is probably one of the lowest in the state.”

In 2016, MedStar took in $5.1 million in revenues, but it cost the company $7.5 million to operate. The losses, Schleicher testified, were absorbed by his company. The company receives “no tax dollars,” Schleicher said.

The options MedStar is faced with are cutting staff, cutting ambulances or asking taxpayers for help to cover the potential added losses that could come with an additional cut to the state’s Medicaid reimbursement.

The commission heard from nearly two dozen ambulance providers at Tuesday’s public hearing. The proposed cuts won’t go into effect until HHSC Executive Commissioner Charles Smith approves them, according to agency spokeswoman, Carrie Williams.

The testimony heard Tuesday could change the commission’s mind in cutting the proposed Medicaid reimbursement rates. A final answer is expected by Oct. 1; the date all new HHSC reimbursement rates go into effect in Texas.

 

 

 

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