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FOR IMMEDIATE RELEASE: December 12, 2013


Ambulance Providers Across Upstate NY are Shortchanged by the Current Medicare Payment System & Will Lose Critical Funding In 2014 If Senate Doesn’t Act – Schumer Pushes for Over $40 Million In Medicare Reimbursements for Ambulances Over The Next 5 Years

With Aging Population and Baby-Boomers Quickly Becoming Eligible for Medicare, Schumer Pushes to Extend Funding Set to Expire, Which Will Allow For Cutting-Edge Equipment, Better Patient Outcomes, and Increased Survival Rates

Schumer’s Plan Will, Over 5 Years, Boost Funding By $3M For Capital Region Ambulances; Rochester FL $2M; Southern Tier $2.3M; WNY $2.2M; North Country $2.8M; Central NY $3M; Hudson Valley $6M

Today, on a press conference call, U.S. Senator Charles E. Schumer launched his fight to protect critical Medicare payments for ambulance providers across Upstate New York, in the amount of over $40 million statewide and $20 million Upstate, which will expire on January 1stif Congress doesn’t act. If these cuts occur, they would hamper ambulance providers’ ability to provide reliable, life-saving services and to invest in the newest medical equipment and procedures for their vehicles. Schumer will fight to avoid this cut, which is the result of an expiring provision, by including it in the Permanent Sustainable Growth Rate (SGR) legislation that will be marked up in the Senate Finance Committee on Thursday. Schumer is fighting to ensure this funding does not expire in the beginning of 2014, and to extend those critical Medicare reimbursements to Upstate New York ambulances for five years at a total value of over $20 million.

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 by 2% for urban and 3% for rural areas 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. From 2000 to 2010, the 60-plus population in New York increased by 15%. Because approximately 40% of patients transported by ambulances are covered by Medicare, expiring Medicare payments are critical to ambulance providers.


“Across Upstate New York, residents deserve top-notch emergency services, but if Congress doesn’t act by January 1st, critical Medicare reimbursements for our ambulances and emergency services will lapse.  Our ambulance providers require these reimbursements – which are already less than the cost of service – to continue to provide the highest quality of care possible and invest in the latest medical equipment,” said Senator Schumer.  “It’s vital that we continue to give ambulance providers fair reimbursement, so I’m pushing a 5-year extension of these supporting funds to be included in the must-pass Sustainable Growth Rate legislation that we will begin considering this Thursday in the Senate. To put it simply, our Upstate New York ambulance services need and deserve this $20 million in payments.”  


Schumer continued, “In many cases, the quality of ambulance service and the technology on board is literally a matter of life and death, so I will spare no effort to see through the extension of these funds for Upstate ambulance providers.”


“We are grateful to Senator Schumer for taking the lead on this critically important initiative,” said James McPartlon, Past President of the American Ambulance Association and Vice President of Mohawk Ambulance Service. “This is a challenged industry and for ambulance service providers, this funding helps provide financial stability. That allows us to replace aging equipment and update technologies, which means we can save more lives."


“This extension will allow many of our EMS agencies to reinvest in the technologies they need to provide high quality patient care.  It will also provide some additional stability as the ambulance industry transitions into the new health care delivery system to make sure emergency medical services will be there when they are needed,” said Andy LaMarca of Mobile Life Support in Newburgh, New York.


“Medicare is the biggest payer that we have,” said Walt Reisner of Trans Am Ambulence in Olean, New York. “A 2-3% cut would be devastating.  It would result in our having increased response times and put life and limb at risk.”


The Balanced Budget Act of 1997 established that beginning in 2002, the way that Medicare reimbursements for ambulance services would be calculated would change, leading to a significant reduction in overall reimbursements.  Under the calculation established by the Balanced Budget Act, reimbursements for services would lag well below the actual cost of service, putting many service providers at risk.  Since 2002, Congress has passed temporary supplemental payments to offset this reduction – often on a year-by-year basis – but still funding lags on average 6% behind the cost of service.  And for rural ambulance providers, where ambulances often have to travel significantly further distances to bring patients to emergency rooms, thus greatly increasing the cost of service, Medicare reimbursements lag even further behind. 


If the relief were to expire, ambulance service providers would be faced with difficult decisions regarding their ability to continue to provide high-quality emergency and non-emergency ambulance services to the communities they serve.  The loss of the funding could lead to reductions in staffing levels, the inability to properly stock ambulances with vital life-saving equipment and drugs and possibly removing an ambulance and crew from service.  In extremely rural areas, it could lead to even longer response times as towns may need to be served by a nearby ambulance service providers covering multiple communities.


Schumer’s amendment would lock-in these supplemental payments to ambulance providers for five years – staving off harmful cuts to Upstate ambulance service providers and giving them certainty that these payments will continue for five years.  Such certainly, Schumer argued, is requisite for these providers to budget and invest in cutting-edge medical technology.


A 2007 Government Accountability Office (GAO) report confirmed that ambulance providers are still 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, between 2008-2013, Schumer secured a temporary increase in payments in Medicare reimbursement. Schumer said that the increased payments provided over the last five years have allowed ambulance providers in New York to make significant updates to their medical equipment and to be more fairly reimbursed for the significant services they provide to Medicare recipients. However, those payments are set to expire on January 1, 2014 and must be included in the SGR legislation being considered in the Senate this month.


On the call, Schumer unveiled county by county data of at-risk Medicare payments for ambulance providers in Upstate New York, which totals over $3.7 million in 2014, and over $20 million over the next 5 years (2014 through 2018):

·                     In the Capital Region, $525,075 in Medicare reimbursements are at-risk in 2014, and $3,015,115 from 2014-2018

·                     In Western New York, $398,744 in Medicare reimbursements are at-risk in 2014, and $2,289,667 from 2014-2018

·                     In the Rochester-Finger Lakes Region, $338,731 in Medicare reimbursements are at-risk in 2014, and $1,945,071 from 2014-2018

·                     In the Southern Tier, $417,600 in Medicare reimbursements are at-risk in 2014, and $2,397,949 from 2014-2018

·                     In Central New York, $521,740 in Medicare reimbursements are at-risk in 2014, and $2,995,939 from 2014-2018

·                     In the Hudson Valley, $1,075,579 in Medicare reimbursements are at-risk in 2014, and $6,176,179 from 2014-2018

·                     In the North Country, $498,265 in Medicare reimbursements are at-risk in 2014, and $2,861,136 from 2014-2018

According to the Ambulance Association of America, increased funding over the last several years, since Schumer first successfully boosted reimbursement in 2008, 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 lifesaving fluids and medications to victims of cardiac arrest, heart attack, and serious trauma.


Increased reimbursements for an additional five years will enable ambulance providers to keep up with technological advances, and purchase life saving devices.  Schumer provided a number of examples of medical devices that are considered “standard of care,” a legal term for the requirement of care under a given medical situation, that can be costly for ambulance providers.  These standard devices should be included in all ambulances, but would be difficult to purchase and install if ambulance service providers had their funding cut.  For example, diagnostic-quality lead electrocardiograms, which can send a patient’s electrocardiograms directly to an emergency department physicians are considered standard of care.  The machines make a difference in whether a patient suffering from a heart attack lives or dies, and cost up to $35,000 each.

In additional, the ability to measure end-tidal carbon dioxide, the amount of carbon dioxide that a patients expires with each breath they take is a standard of care.  It allows paramedics to assess how well a patient’s respiratory system is working.  These devices cost $3,000 - $4,000 each.  Electronic medical records (EMR) are the standard of care everywhere in healthcare today.  The cost, both hardware and software, of adding EMR to a single ambulance can be $7,000 or even more.  When a patient needs a lifesaving medication or fluid, and an IV cannot be obtained, intra-osseous access, which is a needle inserted directly into the bone cavity, is the only way to deliver these life-saving medications.  Each disposable, single-use needle can cost $115.  Schumer said that for Upstate ambulances to continue to purchase these lifesaving medical devices, his amendment guaranteeing supplemental Medicare payments must be passed.


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