The health and safety of everyone in the Commonwealth depends on Emergency services being able to do their jobs. EMS Providers in Pennsylvania are currently in crisis, with many making the difficult decision to end services entirely, due to inefficiencies in the current system through which they are paid and/or reimbursed. Under the current law, Medicare pays EMS directly and private insurers often send reimbursements directly to the patient, rather than the EMS Provider, thus resulting in providers not receiving ample compensation for their services, if any at all.
A Potential Solution: House Bill 1152
House Bill 1152 in the Pennsylvania General Assembly, sponsored by congresswoman Jill Cooper, is an amendment to The Insurance Company Law of 1921, which outlines how EMS providers in the state are reimbursed through Medicare and other insurance providers.
The proposed new law amends this process and aims to make it easier and more efficient for EMS providers to receive compensation. It will allow EMS agencies to seek reimbursement directly from insurers for services provided and require those insurers to directly reimburse EMS providers within 45 days at 350% of the current published rate for ambulance services. The new law also states that insurers may not require an EMS agency to contract with the insurer to receive reimbursement in order to collect. House Bill 1152 was referred to the Veterans and Emergency Services committee and is currently awaiting action.
What This Means for Public Entities
If this bill passes and becomes law, it will bring much needed financial stability to emergency services. This will mean more reliability and reduced risk of service gaps that could impact public safety.
How to Stay Informed
As this important legislation moves through the Pennsylvania General Assembly, we’ll continue monitoring its progress and will update you on any implications for your school’s insurance coverage.
Questions about how changes in EMS legislation might affect your public entity’s insurance needs? Contact our team for guidance tailored to your organization.
