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Ambulance squads could lose $1.37 million in Medicare reimbursement


North country ambulance squads stand to lose a total of $1.37 million in Medicare reimbursement through 2018 if the federal government doesn’t act on an expiring provision, according to a news release issued Wednesday by U.S. Sen. Charles E. Schumer.

Private, nonprofit and volunteer squads in St. Lawrence, Jefferson, Lewis, and Franklin counties could lose $239,079 in Medicare reimbursement for 2014 alone, which some local providers say will just add to the present financial pressure.

Before that happens, Mr. Schumer said, he will “fight to ensure this funding does not expire in 2014.” According to the news release, Mr. Schumer aims to include a five-year extension of funds in the Permanent Sustainable Growth Rate legislation that the Senate Finance Committee will work on today.

“Across upstate New York, residents deserve top-notch emergency services, but if Congress doesn’t act by Jan. 1, critical Medicare reimbursements for our ambulances and emergency services will lapse,” he said in the release. “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.”

According to the news release, Medicare reimbursements for ambulance squads began decreasing in 2002, even though reimbursements would “lag well below the actual cost of service.” Since then, Congress passed temporary supplemental payments, on a year-to-year basis. Extending that to five years will allow squads to continue operating at more sufficient levels.

Increased costs met with lower reimbursement rates is an issue that many area squads are experiencing. At Thousand Islands Emergency Rescue Service, Clayton, Executive Director Roland G. Churchill said IV catheters have gone up 300 percent in the last few years, and in seven years, purchasing a cardiac monitor outright has gone from $12,000 to $31,000.

“If it’s not adjusted, we’ll get stuck with that rate in 2014 and beyond,” Mr. Churchill said. “Our survivability to operate is probably in jeopardy because we cannot operate at a loss.”

Mark A. Deavers, Gouverneur Rescue Squad director of operations, said with a $700,000 annual budget, there’s only a little wiggle room left. So long as a cut isn’t long-term, the squad will survive, he said.

As squads face this Medicare issue, Mr. Churchill said, there is some good news: the summertime woe of some squads having to wait upward of 90 days for federal insurance reimbursement has whittled back down to the normal 30-day time frame.

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