Ambulance companies in New York say a new law signed by Governor Kathy Hochul will help their struggling industry get needed resources to better respond to emergency calls.
The law will ensure that ambulance companies that transport a sick or injured person to a hospital will now be directly paid for that service from that person’s insurance company.
Previous WAER coverage of the ambulance "Direct Pay" bill
Jeffrey Call, Chair of the state’s United Ambulance Network, also heads Guilfoyle Ambulance Service in Watertown, New York. He says while that might seem like a small change, it will end millions of dollars in lost payments to ambulance services.
Call says when someone who lives, say, in Albany, gets sick in Buffalo, or Long Island, and needs an ambulance, that service can be considered out-of-network by some insurance companies.
“When you call 911, there is no prescreening for what kind of insurance do you have, or are you in or out of our network,” Call said.
But the ambulance companies still need to be paid for their services. Previously, the insurance company would mail the payment directly to the person who used the ambulance service. And Call says often that money never made it to the ambulance company.
“For many, many years, if you were out of network, most private insurance companies would send the check to the patient or the customer,” he said. “In some cases, those checks got lost in the mail. In some cases, those checks got cashed and the bills didn't get paid. “
He says the new law requires the insurance company to mail the check to the ambulance provider directly.
It was sponsored in the state Assembly by Bill Magnarelli, a Democrat from Syracuse, and in the State Senate by Neil Breslin, a Democrat from Albany.
Call estimates the change will mean an additional $100,000 a year in payments to his company, which completes 12,000 to 15,000 calls a year.
He says the money is greatly needed at a time when volunteer ambulance companies are struggling to find enough drivers and EMT’s to properly staff services.
Call says the ambulance companies would also be on better financial footing if the state’s Medicaid reimbursement rates were higher. Call says the payments for services do not reflect what is known as “the cost of readiness”.
“It isn't the cost of what it takes to take that call right now,” said Call. “It's the cost for the last six hours, the ambulance has been sitting idle, waiting to take the call also plays into that.”
Call says his group plans to ask Governor Hochul and the legislature for better Medicaid reimbursement rates in the upcoming 2024 legislative session.
He says the ambulance companies are also lobbying the federal government for a better rate of reimbursement from Medicare.