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EMS crews want exemption from broker proposal

Rusty Marks
Representatives from about three-dozen ambulance squads from around West Virginia gather on the steps of the Capitol on Monday to stand against a proposal to hire a broker to manage nonemergency ambulance calls.
CHARLESTON, W.Va. -- A group representing ambulance crews from all over West Virginia will ask Gov. Earl Ray Tomblin to exclude ambulance services from a proposal to hire a third-party broker to manage nonemergency medical transport.The ambulance group would want the exclusion unless the Legislature scraps the proposal altogether.An out-of-state auditor recently concluded that the West Virginia Department of Health and Human Resources could save more than $5 million a year by hiring a broker to manage Medicaid and other insurance reimbursements for nonemergency medical transports -- things like taking patients to doctors' appointments or scheduled medical procedures. Medicaid, Medicare and other insurance providers currently pay for part of such transports or reimburse relatives or family members who take relatives to appointments or procedures.Lawmakers think a broker could negotiate cheaper reimbursement rates or provide transport services for less.Chris Hall, executive director of the West Virginia EMS Coalition, said a broker program could hurt public ambulance services and privately owned ambulance companies. Hall said many ambulance services, particularly in rural areas, count on Medicaid reimbursements from nonemergency calls to subsidize emergency ambulance service.About 200 paramedics and EMTs from 35 to 40 ambulance squads gathered Monday on the steps of the Capitol to stand against the proposed broker system.
Hall and Lincoln County EMS Director Trish Watson fear that a broker system will leave county and local ambulance services out of the loop when a nonemergency call is made, or that reimbursements will be so low that local ambulances won't be able to afford to keep operating.The broker would be able to negotiate reimbursement rates and transport costs and dispatch nonemergency calls. Hall and Watson worry that will mean only one carrier in an area will get all the calls. "This is a for-profit industry," Watson said.Although some counties have ambulance levies to help pay for EMS services, Hall said West Virginia has no dedicated funding source for ambulances. Reducing overall revenue for EMS services could cause the organizations to cut back on services or close shop altogether, meaning longer wait times for patients in legitimate emergencies because an ambulance will be coming from farther away, Hall said.County and local government-run ambulance services have historically resented competition from private ambulance companies for nonemergency calls, but Hall said private haulers also could be hurt by the brokerage proposal if their ambulance service isn't the one picked or if reimbursements are too low. "Some of the people represented here today are private haulers," he said.Hall said ambulance crews would prefer the state not adopt a brokerage system at all. But if they do, they want ambulance services excluded from the law. Hall said the EMS Coalition is sending a letter to Tomblin asking that ambulances be excluded from any broker deal."Many of our surrounding states have brokers, but they don't include ambulances," he said. Hall said Kentucky, Ohio and Pennsylvania are among states that exclude ambulance carriers from the broker system.Reach Rusty Marks at or 304-348-1215.
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