Ambulance providers say payment issues worsen access. Bill sets out-of-network rates

Half of Indiana counties contain “ambulance deserts” — an area where residents live more than 25 minutes from where an ambulance is stationed. Ambulance providers say payment issues are one factor in that lack of access.

A bill passed by the Senate would establish requirements for how health plans pay out-of-network ambulance providers.

HB 1385 would require health plans to pay out-of-network ambulance providers for transports at rates set by a county or municipality. If there is no local rate, insurers would pay the lower of two options: the provider’s billed charges or 400 percent of the Medicare base rate.

Justin Ferrell is the COO of Trans-Care Ambulance. He said ambulance providers don’t always receive payment for their services under the current set-up — which can make employee recruitment and retention complicated.

“We lost 200 employees and they were all technicians,” Ferrell said. “No management, nothing like that — all technicians, and we lost them because of wage wars. Hospitals were able to pay more.”

Providers said lack of payment on top of other financial issues, such as low reimbursement rates and rising costs of equipment, is leading people to flee the industry. This can put more strain on those who remain as need grows and resources shrink.
 

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The bill would not effect a number of insurance plans that the state cannot regulate under federal law. The author of the bill said it would also not impact state-employee health plans and Medicaid to ensure there was no fiscal impact in a non-budget session.

Ashton Eller, with the Indiana Chamber of Commerce, raised concerns about the effect this could have on the business community and said this isn’t the best approach to the problem.

“This is only going to get passed down to small players through insurance premium increases, which may then be passed on to small employers’ employees,” Eller said. “And that's not the way that we'd like to see this problem solved.”

The bill was passed by the Senate and now goes back to the House. It can send the measure on to the governor or take it to a conference committee for further work.
 

Abigail is our health reporter. Contact them at aruhman@wboi.org.