"We want to make sure that beneficiaries get needed ambulance services and that Medicare pays ambulance suppliers fairly and accurately," Donna Shalala, Health and Human Services secretary under former President Clinton, said in early 1999.

Monday, February 05, 2001

"We want to make sure that beneficiaries get needed ambulance services and that Medicare pays ambulance suppliers fairly and accurately," Donna Shalala, Health and Human Services secretary under former President Clinton, said in early 1999.

Now, nearly two years later, Gold Cross Ambulance Service is questioning whether Medicare is being fair in the fees it now proposes to pay for emergency ambulance services in Austin.

By law, Medicare pays for medically necessary ambulance services when other forms of transporting patients would endanger their health. From 1965 to 1985, Medicare collected information from ambulance service providers and averaged the results to arrive at a cap charge. The charge usually increases by 1 percent every year to accommodate increases in the costs of providing the service.

The 1997 Balanced Budget Amendment moved ambulance payments to a national fee schedule at the same time it required ambulance services to accept the Medicare allowance as payment in full.

Gold Cross, a service of Mayo Medical Transport, is a non-profit organization that returns the money paid above the service costs back to the community in the form of training and community services. The current proposed amount paid to Gold Cross by Medicare is only 45 percent of the service costs provided, meaning that Gold Cross will be running at a deficit and will require further subsidizing.

"The statewide loss from this charge is estimated at $17 million," according to a news release issued by the Rochester-based Gold Cross. "The combined estimated impact of mandatory assignment and the change to a fee schedule on Minnesota ambulance providers is estimated at $37 million."

Ambulance services in Kentucky and Texas already have gone out of business, unable to keep services running with a lack of Medicare funding.

"Huron Hospital of East Cleveland, Ohio, announced Oct. 13 that it was losing $250,000 to $400,000 annually by providing ambulance service and asked the city to take over EMS by April 1," according to the Gold Cross release.

No services have been discontinued in Minnesota, however, and Glenn Lyden of Gold Cross said they are working to implement "strong expense controls and cut costs through group purchases" throughout the Gold Cross network in Minnesota communities.

"In rural America, ambulance service is the safety net for health care," Lyden said, stressing how vital the service Gold Cross provides is to the Austin community.

The original target date for the ambulance fee change was Jan. 1. However, the fee schedule was not complete, so the date was pushed back to Feb. 1. Now it appears the change will be implemented in April.

"We have no plans to change our service in Austin," Lyden added. No staffing changes have been discussed as of right now.

Lyden said residents who are concerned about the issue should contact their senator or representative and voice their opinion.

"We need to get word out to the members of Congress," he said.