The problem with Medicare reimbursement.
The air medical industry is faced with dramatically low reimbursement by government payers (Medicare, Medicaid, and other forms of government health insurance).
The reimbursement rates under these programs fall dramatically below the true costs of providing service: the average Medicare reimbursement only covers 50% of actual transport costs, and in many states, Medicaid covers far less (as low as 1/25 of Medicare in some states).
This is a threat to the health care system because 70% of transports are patients who have Medicare, Medicaid, other government insurance, or are uninsured.
How can we fix Medicare reimbursement rates to protect this part of the health care system?
In June 2023, U.S. Senators Michael Bennet (D-CO) and Marsha Blackburn (R-TN) and Representatives Ron Estes (KS-04) and Suzan DelBene (WA-01) introduced the Protecting Air Ambulance Services for Americans Act of 2023 - a bipartisan, bicameral bill to modernize Medicare reimbursement rates for air ambulance service.
This legislation would give the Centers for Medicare and Medicaid Services (CMS) the authority to update Medicare reimbursement rates based on transport cost data already being collected by the U.S. Department of Health and Human Services (HHS) under the No Surprises Act. This legislation would also require the Government Accountability Office (GAO) to produce a report analyzing average costs per base and transport, the payor mix for air ambulance services, adequacy of Medicare reimbursement, geographic variations in costs of providing services, and other key factors that will help improve the air ambulance fee schedule.
We encourage Congress to pass the Protecting Air Ambulance Services for Americans Act to ensure air medical providers are reimbursed appropriately. If passed, air medical bases will no longer be forced to close down and they will be able to continue providing lifesaving care and transport for the millions of rural Americans who are dependent on the service.
Visit the Take Action page to encourage Congress to pass this important legislation.