— New bill Sets Maximum Reimbursement of $3,325 for Transport.
HARRISBURG, PA — The new state budget increases state Medicaid reimbursement rates to help patients deal with sticker shock for costly emergency airlift bills.
The fiscal code, House Bill 1929, includes a new maximum reimbursement of $3,325 for an air ambulance transport, a major increase over the previous maximum reimbursement of $200 per air transport, said Rep. Tina Pickett, R-Bradford, on Monday. Picket chairs the House Insurance Committee. It sets a mileage reimbursement rate floor of $22.45.
Pickett chaired a committee hearing in early 2017 during which patients discussed facing bankruptcy because of emergency air ambulance bills in the tens of thousands of dollars.
At that hearing, one patient in Northeast Pennsylvania told of being billed $42,000 for a 24-mile flight. His private insurer would only cover part of the tab.
In some cases, private insurers denied the claim, said Pickett.
She noted the previous $200 maximum reimbursement per transport was unsustainable since the cost of fuel for one trip is about $450.
The increase was negotiated as part of the fiscal code when the state budget for Fiscal Year 2018-19 was enacted last month, Pickett said.
“I am hopeful that increasing the Medicaid reimbursement will help these companies offset their expenses and not spread the burden out to other consumers,” she said. “I also hope that increasing the state reimbursement will also lead to other insurers picking up more of the tab. Air ambulances are literally life-saving services, especially in our rural part of the state.”
The Fiscal Code also increases Medicaid reimbursement for traditional ambulance services, both operating for-profit and as volunteer.
Reimbursements for Advanced Life Support will be increased from $200 to not less than $300 and Basic Life Support will be increased from $120 to $180, effective Jan. 1, Pickett said.
This is the first increase in Medicaid reimbursement for the state’s ambulance companies since 2004, said Pickett.
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