WHAT IS Bill S1466/A250A?
This bill, which has already been passed by the NYS Senate and the NYS Assembly, “authorizes payments to nonparticipating or nonpreferred providers of ambulance services licensed under article 30 of the public health law.” At the time of this article’s writing, this bill is now waiting for New York Governor Kathy Hochul to sign into legislation.
While the main premise of this bill is to ensure that insurance-covered costs be paid directly to the ambulance company that facilitated the transport and care of a patient, there are many who oppose the bill’s inception. Insurance companies are generally opposed to the bill saying that it would harm the network of preferred providers as well as potentially raising costs for EMS transport. The NY business council also objects stating “legislation will lead to higher prices for ambulatory services and negatively impact employers and consumers with increased health plan costs”.
As one CEO of a NY-based ambulance corps said, “Unless ambulance providers have contracts as preferred providers with an insurance company, the insurer sends the reimbursement check directly to the patient. The patient of course is expected to pay the ambulance provider, but frequently they would simply cash the check, leaving the ambulance provider to undergo collection actions. When signed into law by the governor this will truly help ambulance services with financial stability.”
For anyone who has been on the billing side of any ambulance corps in NYS, this bill would help to pay some of the cost of operations, transport of patients, and necessary supplies used en route to the ER. All too often, when the ambulance service is NOT part of the insurance company’s preferred provider list, any reimbursement for transport goes to the patient. Unfortunately, several patients forget to forward these payments to the respective ambulance company, sometimes it gets lost among all of the other medical paperwork the patient receives, and a few choose not to forward the money at all. In any case the ambulance company fails to receive reimbursement for the service provided, payments which would help cover the cost of truck maintenance, patient supplies, and staff.
Many NY-based ambulance corps have suffered from the rising cost of keeping their ambulances on the road, including fuel, vehicle insurance, and patient supplies, as well as suffering a serious loss in personnel over the past few years. NYSVARA has also issued a plea to the Governor to sign and pass this bill saying, “that fair and direct insurance reimbursement for EMS calls is paramount to financial stability and continued availability of ambulance services to serve our patients and communities. Volunteer EMS responders report to shifts around the clock and are at the ready to assist the ill and injured. Signing this legislation into law will help ambulance squads by increasing the percentage of the payment intended for ambulance service that actually gets to the ambulance squad.”
More than one NYS EMS agency has contemplated, or already decided, to close operations due to lack of funding and a volunteer/workforce shortage — leaving wide areas where there is no EMS response for the local community. Let’s hope that the Governor hears our pleas and signs this bill into law as soon as possible.
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