Introduction of the Medicare Ambulance Access Preservation Act

Floor Speech

INTRODUCTION OF THE MEDICARE AMBULANCE ACCESS PRESERVATION ACT -- (Extensions of Remarks - May 14, 2009)

* Mr. NEAL of Massachusetts. Madam Speaker, I rise today to introduce the Medicare Ambulance Access Preservation Act. This bill would ensure that my constituents in Massachusetts, and people across the country, continue to have access to ambulance services. Ambulance service providers are a critical part of our country's first responder and health care systems. In fact, as we discuss how to reform our health care system I can think of nothing more fundamental than ensuring that people have access to life-saving emergency ambulance care.

* We all know the importance of ambulance services. Many of us see them every day transporting ill or injured individuals to the hospital. Some of us have even been transported and received pre-hospital care in an ambulance. Dedicated, skilled professionals work in these ambulances, ensuring that patients receive the care they need and ensuring that communities are prepared in the case of a disaster. The need to ensure the availability of these services is clear. Yet, Medicare reimbursement policy has harmed rather than helped to reach this goal.

* Under the Balanced Budget Act of 1997, Congress authorized the Centers for Medicare and Medicaid Services (CMS) to develop a Medicare ambulance fee schedule. The rates developed under the fee schedule were significantly below what it cost many providers in Massachusetts to deliver services. In May 2007, the Government Accountability Office (GAO) confirmed this problem by determining that Medicare reimburses ambulance service providers on average 6 percent below their costs and 17 percent below cost in ``super rural'' areas. Ambulance providers aren't even breaking even in Medicare--Medicare reimburses ambulance providers below their costs for every person they transport.

* Congress has recognized this shortfall and included temporary Medicare ambulance relief provisions in both the Medicare Modernization Act (MMA) and the Medicare Improvements for Patients and Providers Act (MIPPA). However, all of these provisions expire at the end of 2009. To address this problem, I have worked with ambulance service providers in my state to develop a permanent Medicare relief package.

* My legislation would increase reimbursement to rural and urban ambulance suppliers by 6 percent, and super rural providers by 17 percent. These numbers are consistent with the GAO report. This package will ensure not only continued availability of ambulance services, but also that ambulance service providers will be able to maintain standards of providing quality health care to patients.

* As we address health care reform, we must begin by remembering the basics. Ambulance services are a fundamental part of our health care system. Congress must ensure that all Americans continue to have access to ambulance services and that the dedicated men and women who provide ambulance services have the tools and resources they need to serve patients when timely, expert medical care is needed most. I ask my colleagues to join me in this effort by cosponsoring this important legislation.

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