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FOR IMMEDIATE RELEASE: February 21, 2012


Ambulance Providers Across Upstate New York Were Shortchanged by the Current Medicare Payment System - Schumer Has Passed Legislation Several Times To Provide Relief But Provision Kept Expiring <> As Part of Payroll Tax Package, Schumer Secures Additional Year of Medicare Investments That Will Allow For Cutting Edge Equipment, Better Patient Outcomes, and Increased Survival Rates <> Schumer: This Plan Will Keep Our Rural Ambulances’ Wheels Rolling


U.S. Senator Charles E. Schumer today announced that ambulance providers will receive a one year extension of critical Medicare funding, ensuring that they can continue to provide top-notch medical care, particularly in Upstate New York’s rural communities. The provision included in the Payroll – Medicare bill expected to pass today extends the 2% urban, 3% rural and super rural bonus increases from March 1, 2012 to January 1, 2013, which will send an additional $8 million to New York ambulance providers each year. Ambulance providers have continually been shortchanged by Medicare. A May 2007 GAO report found that ambulance service providers are reimbursed on average 6% below their costs of providing services to Medicare patients. Since approximately 40% of patients transported by ambulances are covered by the Medicare program, inadequate Medicare payment is a critical problem for ambulance service providers. 


“Ensuring that our ambulances can continue to serve New York’s rural communities can literally make the difference between life and death,” said Schumer. “Time and time again I’ve fought to make sure that our ambulances are properly and fairly reimbursed for their services, and today’s news is a major victory for the EMTs who work so long and so hard to keep us safe.”


Medicare ambulance payments have undergone major changes in the past 10 years, but a 2007 Government Accountability Office (GAO) report showed that ambulance providers are being under-paid by Medicare, hampering their ability to outfit their vehicles with cutting edge medical equipment and training their emergency personnel and medics in the latest pre-hospital care procedures and treatments. In response to the GAO report and the growing needs of Upstate ambulance providers and patients, in 2008, 2009, 2010 and 2011 Schumer secured a temporary increase in payments in the Medicare. Schumer said that the increased payments provided over the last four years have allowed ambulance providers in New York to make significant updates to their medical equipment. 


Currently, Medicare payments to private, non-profit, and volunteer ambulance providers barely keep up with the cost of equipment upgrades, and the funds are set to be reduced at the end of the year. Schumer noted that well-equipped, well-funded ambulance services and medics who provide life-saving care to patients are more important now than ever, as the population ages and the number of Medicare beneficiaries increase. Low Medicare payments mean ambulance providers lack the necessary funds to acquire train with cutting-edge medical equipment and technology that can make a life-saving difference to patients, but are often too expensive for cash-strapped ambulance companies to afford. Schumer’s successful effort to secure additional funding should help alleviate that problem, ensuring that ambulances are equipped with the lifesaving equipment they need and deserve.


According to the Ambulance Association of America, increased funding over the last several years has enabled ambulance providers in New York to purchase equipment, such as Automated External Defibrillators, which reduces the time a victim of cardiac arrest suffers from the most common lethal cardiac arrhythmias, and Intraosseous (IO) Infusion devices, which allows paramedics to deliver life saving fluids and medications to victims of cardiac arrest, heart attack, and serious trauma. As blood pressure falls it is increasingly difficult for even the most highly skilled technician to obtain intravenous access to deliver life saving care. In those cases, adult intraosseous (IO) infusion, a procedure where a needle is placed into the bone marrow of one of the long bones in the leg, provides critical access to the circulatory system for patients that need it most. Like most new medical technologies, IO infusion is expensive. Reducing Medicare reimbursement for ambulance services could threaten access to this important medical procedure.


Increased reimbursements for an additional year will enable ambulance providers to keep up with technological advances, and purchase life saving devices like the Waveform End Tidal CO2 (Capnography), used in endotracheal intubation, one of the most important and dangerous procedures performed by paramedics in the field. The procedure is so dangerous for patients because an undetected, misplaced endotracheal tube is potentially lethal.  Waveform capnography is a powerful tool that reduces or eliminates the incidence of undetected misplaced endotracheal tubes. It allows paramedics to more closely monitor their patients during transport to ensure that their airway is secure.


Increased reimbursement will also allow for ambulances to purchase Automatic Compression CPR Devices that expand the capability of the paramedic as they care for a victim of cardiac arrest. These devices through either a piston system, or a band that fits around the patient's chest automatically compresses the chest at the correct rate and to the correct depth ensuring that the patient receives textbook quality CPR. In addition, because the paramedic does not have to pause to perform cardiac compressions, the medic is free to administer medications, perform airway procedures, or provide other life saving care. These devices are new, and very expensive. With the threat of reductions in Medicare payments, ambulance services may not be able to afford these potentially life saving devices.


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