By Savannah Tryens-Fernandes, AL.com
U.S. Rep. Terri Sewell introduced a bipartisan bill this week to increase Medicare payments for ambulances to help fix the crisis plaguing communities throughout Alabama and the country.
Medicare reimbursements for ground and air ambulances have not been updated since 2002, according to the group of representatives sponsoring the Reimbursing Emergency Services for Critical Urgent Encounters (RESCUE) Act.
That means the current rates emergency services are being paid by Medicare are based on data from 1998, even as the cost of things like gas and medical equipment have gone up.
“I cosponsored the bipartisan RESCUE Act because it will help ensure ambulance services are fairly reimbursed for the lifesaving care they provide, strengthening emergency medical services and helping keep ambulances on the road for the communities that depend on them,” Sewell (D) said in a statement to AL.com.
Alabama has the second lowest number of ambulance stations per capita in the country, according to a 2023 report by the Rural Health Research and Policy Centers.
Of the state’s 67 counties, 64 are considered to be in an ‘ambulance desert,’ impacting over 300,000 people, mostly in rural communities. Many rural counties have lost medical services in recent years as hospitals downsized or closed completely.
Earlier this month, Greene County Emergency Medical Services halted their ambulance service because a “critical lack of funding” had prevented them from maintaining their ambulances.
Residents were told there was only one quick response vehicle available to take patients to the hospital, and they “should expect significantly delayed response times” for emergencies.
But days later, local and state officials secured money for two new ambulances from the state’s EMS office.
Local officials told AL.com that the new ambulances are only a short-term solution. In order to keep them on the road, emergency services will need higher payments from Medicare and other insurance providers.
“The biggest clients that the ambulances have in Greene County are Medicaid and Medicare patients,” said Garria Spencer, chair of the Greene County Commission.
“We have got to have a source of income other than what they’re billing because they’re just not billing enough to make it work, and that’s not only true in Greene County.”
The RESCUE Act would require the Centers for Medicare and Medicaid Services to update ambulance payments every three years based on current data on mileage and labor costs.
The new payments would take effect in 2029, according to the bill, which has the support of the Emergency Ambulance Operators Alliance.
“When Alabamians call 911 during a medical emergency, they deserve to know that an ambulance will be there when they need it,” Sewell said.
“Unfortunately, too many families—especially in our rural communities—are facing longer response times because ambulance providers are under tremendous financial strain.”
Savannah Tryens-Fernandes is an investigative reporter covering health and medical care in Alabama. She joined AL.com as an education reporter and Report for America corps member in 2021, covering efforts to address child mental health and wellness inside and outside classrooms. Savannah previously documented human rights abuses in Southern Africa while working at Human Rights Watch. She also holds a master’s degree from Columbia Journalism School, where she was a Stabile fellow in investigative journalism.
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