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EMS funding bill, approved by Senate, moves to House

The legislation would increase from $100 to $175 over three years the fees paid EMS providers for transporting Medicaid patients to hospitals and would expand when they are eligible to be reimbursed for other services. (The Daily Record/File Photo)

A Maryland Association of Counties-led bill to increase the amount of Medicaid reimbursement emergency medical services providers receive when they perform their duties is making its way through the General Assembly, having successfully passed the Senate last week. 

The bill, SB295, looks to increase the rate EMS providers are reimbursed for the transportation and medical costs of taking a patient to a hospital, in hopes of bringing that rate up to meet the impact of inflation. Currently, EMS providers are paid $100 each time they transport a Medicaid patient to a hospital, a rate that was set over 20 years ago in 1999 and has not been raised since. If passed, the legislation would gradually increase that rate to $175 over three years.  

“An increase to this rate is long overdue. A lot changes in 20 years, especially costs. Prices of ambulances, supplies and other necessary tools our first responders need to provide adequate service in emergency stations has risen drastically,” Sen. Jason Gallion, R-Cecil and Harford, the bill’s sponsor, told the Senate Finance Committee at the bill’s hearing in early February. 

Originally, the bill sought to increase the rate to $300 — a rate that Gallion said is on-par with nearby states — over eight years, but an amendment added in the Senate lowered the final reimbursement rate. 

The bill would also expand when EMS providers are eligible for these reimbursements. Currently, if paramedics give a patient medical care and then the patient refuses to be transported to a hospital, the EMS provider receives no reimbursement; this bill seeks to ensure that the provider will receive reimbursement for each such interaction.  

It would also allow EMS to be reimbursed for delivering non-emergency care, called “mobile integrated health service,” to patients. Mobile integrated health care is usually delivered in partnership with a local hospital or health system, and is defined in the bill as bringing primary, preventive, chronic, preadmission or post-admission health care service or transport to a patient. Gallion said 11 counties in Maryland use mobile integrated health services. The bill also includes a study on best practices for the reimbursement of mobile integrated health services in other states across the country. 

One of the bill’s advocates, Laura Price, president of the Maryland Association of Counties’ Board of Directors and a Talbot County councilwoman, stressed the importance and quality of the care paramedics often provide even before they leave the site of an emergency.  

“Just before Christmas, 911 was called for me and I was in awe at how much medical care was given to stabilize me before I ever left the driveway. Though I was transported to an ER, it’s imperative that we have the capability to compensate these true health professionals for treatment in the field, and under our current system, that doesn’t happen and that needs to change,” she said. 

Finally, the bill would allow paramedics to transport patients to non-emergency facilities, like urgent care centers, depending on their needs. 

Representatives of the Maryland Institute for Emergency Medical Services Systems, Frederick County Fire and Rescue Services Division, and the Maryland State Firemen’s Association spoke in favor of the bill, as did Harford County Executive Barry Glassman and Stephen Wantz, a Carroll County Commissioner. County officials from Anne Arundel, Baltimore County, Frederick County, St. Mary’s County, Cecil County and Montgomery County also submitted written testimony. 

The bill’s proponents spoke to how the legislation would ease the burden on Maryland’s emergency rooms, which have struggled to keep up with demand, especially during the pandemic, and would make it easier for EMS providers to continue serving their communities. 

The bill, which passed unanimously in the Senate, will be heard in the House of Delegates Health and Government Operations Committee on Wednesday. 

MACo lauded the bill’s success thus far. 

“It is a victory in and of itself to still be on the board at this point during legislative session, and this bill is very much still alive,” the association wrote in a blog post. “The next three weeks will be make or break for EMS funding reform, and it is entirely possible events may run to the last second on Sine Die.”