By Joe Lawlor
Portland Press Herald
WASHINGTON — U.S. Sen. Susan Collins on Monday introduced a bill that would permit Medicare to reimburse EMS providers even when the patient is not transported to a hospital.
Collins, R- Maine, and Sen. Joe Manchin, I-West Virginia, proposed the payment reform as a pilot program to help boost reimbursements for EMS, which will help the financial stability of ambulance services, especially in rural areas.
Companion legislation was introduced in the U.S. House this summer and Maine Reps. Jared Golden and Chellie Pingree, both Democrats, signed on as co-sponsors. Sen. Angus King, I-Maine, is reviewing the legislation, his office said.
“Having access to high-quality emergency medical services is essential for individuals in rural communities across Maine and the nation,” Collins said in a written statement. “This bipartisan bill would expand the treat-in-place model for EMS services, reducing unnecessary emergency room visits, lowering costs, and easing the strain on our state’s hospital and EMS workforces.”
About a year ago, Sen. Peter Welch, D- Vermont, also proposed a bill to pay for ambulance services that did not result in hospital transport, but that bill did not get a committee hearing.
Gov. Janet Mills signed into law in 2023 a similar measure at the state level requiring private insurance carriers to reimburse for EMS services regardless of whether the patient is transported to a hospital. However states do not regulate Medicare, so any Medicare patients would not be affected by the Maine law.
Sometimes people call 911 and when ambulances arrive, responders determine that the patient does not need hospital treatment. In those cases, EMS is not reimbursed for the call for Medicare patients, even when providing on-scene treatment to the patient.
Robert “Butch” Russell, executive director of the Maine Ambulance Association, said in a written statement that “this legislation will directly address the funding gap for non-transport calls, helping to ensure that EMS systems remain viable and able to meet the growing demands of our communities.”
Thomas Higgins, president of the Maine Fire Chiefs Association, said in a written statement that “on-scene care is a viable option for our patients in many instances and should not result in additional burden. This legislation will provide direct financial support to our communities and the services we provide.”
The Maine Hospital Association, the National Rural Health Association, the American Ambulance Association and several other similar advocacy groups support the legislation.
Maine’s EMS services have struggled financially in recent years and state lawmakers in 2023 approved $31 million to help keep EMS services afloat. There’s debate over how to divvy up the money, and so far about $20 million has yet to be spent.
Lawmakers have also attempted to regulate “surprise billing” in which patients receive exorbitant bills for out-of-network ambulance transports. State lawmakers have passed some consumer protections, but loopholes remain and more encompassing regulations would need to be passed at the federal level. Ground ambulance services were left out of the federal No Surprises Act, which passed as part of COVID-19 relief legislation, and regulates surprise medical billing.
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