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Ambulance companies say new law will help them remain solvent

This stock image shows the front entrance sign to a hospital's emergency room department.
Annette Shaff
Adobe Stock
This stock image shows the front entrance sign to a hospital's emergency room department.

Ambulance companies in New York say a new law signed by Gov. Kathy Hochul will help their struggling industry get needed resources to better respond to emergency calls.

The law will ensure that ambulance companies that transport a sick or injured person to a hospital will now be paid directly for that service from that person’s insurance company.

Jeffrey Call, chair of the state’s United Ambulance Network, also heads Guilfoyle Ambulance Service in Watertown. He said while that might seem like a small change, it will end millions of dollars in lost payments to ambulance services.

As an example, Call said when someone who lives in Albany gets sick in Buffalo or Long Island and needs an ambulance, that service can be considered out-of-network by some insurance companies.

“When you call 911, there is no prescreening for what kind of insurance do you have, or are you in or out of our network,” Call said.

But the ambulance companies still need to be paid for their services. Previously, the insurance company would mail the payment directly to the person who used the ambulance. And Call said that money often never made it to the ambulance company.

“For many, many years, if you were out of network, most private insurance companies would send the check to the patient or the customer,” he said. “In some cases, those checks got lost in the mail. In some cases, those checks got cashed and the bills didn't get paid.”

He said the new law requires the insurance company to mail the check to the ambulance provider directly.

It was sponsored in the state Assembly by Bill Magnarelli, a Democrat from Syracuse, and in the state Senate by Neil Breslin, a Democrat from Albany.

Call estimated the change will mean an additional $100,000 a year in payments to his company, which completes 12,000 to 15,000 service calls a year.

He said the money is greatly needed at a time when volunteer ambulance companies are struggling to find enough drivers and EMTs to properly staff services.

Call said the ambulance companies also would be on better financial footing if the state’s Medicaid reimbursement rates were higher. Call said the payments for services do not reflect what is known as “the cost of readiness.”

“It isn't the cost of what it takes to take that call right now,” said Call. “It's the cost for the last six hours the ambulance has been sitting idle, waiting to take the call, also plays into that.”

Call said his group plans to ask Hochul and the Legislature for better Medicaid reimbursement rates in the upcoming 2024 legislative session.

He said the ambulance companies are also lobbying the federal government for a better reimbursement rate from Medicare.

Karen DeWitt is Capitol Bureau chief for New York State Public Radio, a network of public radio stations in New York state. She has covered state government and politics for the network since 1990.