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Politicians Tackle Surprise Bills, but Not the Biggest Source of Them: Ambulances

29 Jul 2019 8:08 AM | AIMHI Admin (Administrator)

NYT source article | Comments courtesy of Matt Zavadsky

Interesting article in the NYT. 

Here are a few of the key statements that illustrate the difference in ambulance economic models, compared to other healthcare providers, and the impact of government subsidies on provider charges:

Congress has shown little appetite to include ambulances in a federal law restricting surprise billing. One proposal would bar surprise bills from air ambulances, helicopters that transport patients who are at remote sites or who have life-threatening injuries. (These types of ambulances tend to be run by private companies.)

But that interest has not extended to more traditional ambulance services — in part because many are run by local and municipal governments.

Anthony Wright, executive director of Health Access California, worked on a 2016 California law to restrict surprise billing. Initially, he thought it made sense to include ambulances in that legislation.

But obstacles quickly began to mount. Some were about policy, like whether California would need to offset the revenue local governments would lose.

Local governments generally finance their ambulance services through a mix of user fees and taxes. If ambulances charge less to patients, they typically need more government funding.

Municipal governments often publish the prices of their ambulance services online, and they can range substantially. In Moraga and Orinda, in the Bay Area, the base rate for an ambulance ride is $2,600, plus $42 for each mile traveled. In Marion County, Fla., the most basic kind of ambulance ride costs $550, plus $11.25 per mile.

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Politicians Tackle Surprise Bills, but Not the Biggest Source of Them: Ambulances

A legislative push in Congress and states to end unexpected medical bills has omitted the ambulance industry.

By Sarah Kliff and Margot Sanger-Katz

July 22, 2019

After his son was hit by a car in San Francisco and taken away by ambulance, Karl Sporer was surprised to get a bill for $800.

Mr. Sporer had health insurance, which paid for part of the ride. But the ambulance provider felt that amount wasn’t enough, and billed the Sporer family for the balance.

“I paid it quickly,” Mr. Sporer said. “They go to collections if you don’t.”

That was 15 years ago, but ambulance companies around the nation are still sending such surprise bills to customers, as Mr. Sporer knows well. These days, he oversees the emergency medical services in neighboring Alameda County. The contract his county negotiated allows a private ambulance company to send similar bills to insured patients.

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