CHARLESTON, W.Va. — Emergency Service providers across West Virginia fear a measure backed by the Tomblin Administration which is aimed at saving money in Medicaid could threaten their ability to survive. The administration advocates a policy which would enable the private transport of non-emergency patients be handled through private ambulance brokers. Emergency Service providers say the governor’s office is  targeting the wrong area.

“The problem is 75 percent of the cost of the program and the majority of the fraud is a ‘friends and family program,’” said Chris Hall with the West Virginia EMS Coalition. “Johnny driving his grandmother to the doctor and West Virginia reimbursing him for what most of us would do as the responsible thing.”

However, to combat the problem, non-emergency transport by non-profit Emergency Medical Service providers is being targeted. The non-emergency transport patients represent 30 to 40 percent of the EMS revenue.

“It would cut our non-emergency trucks and it has the potential to affect our emergency trucks in the rural area,” said Trish Watson head of the Lincoln County Emergency Medical Services.

Emergency leaders fear brokers will cut service in rural ares where profits are slim and many West Virginians in rural communities would eventually be without service or at least service would have sub-par service and long waits for help which would be further away.  It’s possible the county EMS units could be the contractors for the broker, but even that won’t solve the problem.

“All brokers are for profit entities, so they could bring in their own companies or they could contract with us,” said Watson. “DHHR keeps saying they’ll contract with us, but essentially we’ll be doing the same work for less money. If we’re already underfunded, less money isn’t a positive effect.”

The group rallied at the State Capitol on Monday hoping to persuade the administration to consider exempting emergency service transports from the cost cutting measure.

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Comments

  • Barry Bledsoe

    No matter what stories are printed on this fine site, invariably there will be a number of "experts" who think they know what is going on, who want to comment. The responses to this story are no different. Let me see if I can educate the "experts."

    First, some background. The DHHR tried three times to run this through the state legislature, in the form of a bill. This bill would have allowed them to hire an out of state broker, (the rules stated that the bid on this you have to currently be doing business in three states. NO EMS agency in WV currently does business in three other states) to manage all non emergency medical transports in WV. This includes the "Friends and Family" program, which pays family or friends to take someone to a doctor appointment, dialysis, etc. THIS is where most of the problem lies.

    First of all, why should a husband, wife, child, or other family member have to be paid to take their loved one to the doctor? Really? Second, from what I have learned, aside from the fact that we shouldn't be doing this in the first place, there is a LOT of fraud in the program. No surprise there.

    However, when the legislature decided that this was not a good bill as written, the DHHR decided to run around the process and make their own rule, despite what the legislature decided. They must be reading the EPA playbook.

    Also, for the "experts" out there who think this should go through (Dale), this is not about out of control spending. While I agree that costs are out of control at nearly every level in the medical field, consider this: Medicaid reimbursement to EMS has not increased since 2001! Gas was $1.90, insurance and workers comp premiums have tripled, wages have gone up roughly 50%, and the cost of ambulances and equipment have skyrocketed. The purchase price of one heart monitor and difibrillator is $25,000.

    So you see, (Dale) non-emergency calls are not a "cash cow." They are the calls that help pay the bills, and allow us to continue providing emergency service to those who aren't going to pay anyway, and keep from having to raise rates to those that do pay. These are also the calls which help the smaller services keep an ambulance in your town, with staffing to make sure you get the ambulance when you call 911. Without these calls, these break even stations would close. You need to know a little bit about business and finance to understand this, so you may not get it anyway.

    And for someone who hides behind the name of "exmedic," to say that we don't need an "emergency" ambulance to transport someone to dialysis transports, tells me why they are an EX medic. How in the world could you justify the expense to purchase a $100,000 truck, to be used solely for the purpose of transporting non-emergency patients, when you have trucks that can be used for dual purpose? And why would you pay an additional crew just to do this, when there is already a crew or crews in the station who can do emergency and non emergency calls?

    Beard and 2XL hit the nail on the head. The high costs of medicne have nothing to do with Medicaid reimbursements. It has more to do with people who use and abuse the system, as well as lawyers and regulators who push the cost of everthing from drugs to insurance premiums through the roof.

    Any questions?

  • J.P.

    An ambulance is for Emergency Medical Transport. Period. End of Story. If the local ems people want to continue driving people to Dr. appointments, maybe they should use a passenger van or some other vehicle. A fully equipped ambulance should not be tied up for everyday appointments.

  • Kitten

    Unbelievable how all these respondence have such a personal agenda. What about the citizens and old people ems helps everyday. Everyone knows the fire service only does ems to increase volume for money. People against local ems have an ax to grind or are an ex employee disgruntled and can't find a job. Let this happen and look for the old days and funeral home service!

  • Exmedic

    Seems to me that only Jan Care is the true worried ones. They have abused the system for years, over charging using ALS trucks on granny totes, driving out of the way routes to charge more mileage. there is no need to use an EMERGENCY ambulance on dialysis transports. I agree with Hillbilly, turn it all back over to non-profit agencies, the private squads have ruined EMS in this state

    • Kitten

      Bull s___! an emergency ambulance cost wqay more than the few emergency calls they respond to! Should they raise taxes to pay for medics to standby for the next emergency? dumb a__!

  • Hillbilly

    The EMS service are the no more then a big rip off in this state. Get rid of this MONEY PIT IN THE STATE Turn it back to the fire Depts who did a fine job for years

    • Jeff

      Seriously? Turn ambulance service over to the fire service? We can't get enough people to run fire calls unless the dispatcher says fully involved or entrapment!

    • me

      Oh hillbilly lol,
      The fire depts are even having trouble with getting out. I mean really. Fire apparatus responding to with 1 person on board? Really? You want to go there? Don't flatter yourself.

    • 2XLPatriot

      Who's going to pay to staff all the extra required personnel to man an ambulance 24/7? While I started as a volunteer eons ago, it has become a necessity to add paid personnel to provide the coverage when volunteers aren't able.

      • Benny

        Aren't you usually AGAINST socialized anything?

  • DWL

    Yet another "seen" fallout from that magnanimous lead O! Way to go Carpetbagger Jay, No Show Joe and cuz Earl Ray. Turn the services back over to the funeral homes, like it was years ago. They can handle it no matter which way it goes. The stupid liberals and union folks keep electing these idiots, let them digest their morsels. You call, they haul, that’s all.

  • Beard

    Adding to what 2XLPatriot said is that 75% of the people we take to the EDs for these bs calls do not have insurance. So when said "patient" gets the bill for the trip they usually do not pay it and it goes off to collections where it could be years before the agency could see some money for the transport. Emergency traffic is where we lose money. I do not know one EMS agency in WV that can fully self support on just Emergency traffic. EMS workers in this state average around $25k a year. We do not do this job for the money, but the money makes sure that the patients get the care they need.

    @Dale go back to your hole with your monthly checks and free phones.

    • Dale

      If you don't do it for the money Beard, quite whining about making 25k. Go to school and improve your life!

      • Beard

        I have gone to school. I have a BA in economics, BA in history, and a BS in geography. I went to school to be a teacher but fell in love with a different profession. I choose to take care of people and visually make a difference in their lives while they are in the back of my truck.

  • 2XLPatriot

    What I doubt you realize here Dale, is the fact that reimbursment for non-emergency transports are only a portion of what they actually cost the EMS agency. The real problem is the abuse of the 911 system. 911 calls for sore throats, ear aches and a slew of other BS is the issue. I have personally transported people to the ER for A pregnancy test! The other problem is the fact that EMS cannot refuse to transport these people regardless of the ridiculousness of their complaint when they call 911. Stop paying Mom or Dad for taking their kid to the hospital for a runny nose or to a routine Doctors appointment. Yep! They're called vouchers and they get paid mileage and a stipend for a scheduled appointment. The average 911 call is reimbursed about 15- 20% of the actual costs incurred. 30 - 40% reimbursement of non-emergency transports for people who have an actual medical need to be transported by ambulance is not a "cash cow". It's a necessity. I would personally prefer to have my county or non-profit agencies receiving those monies that we know would go right back into the community by ways of training, equipment and more personnel than to an individual who owns some ambulances.

    • Dale

      If your actually being reimbursed at 15-20% and 30-40% why not allow private sector involvement?

      • 2XLPatriot

        Private sector service drives up costs and most employ substandard personnel. CPR certified drivers and an EMT. Most non-profit agencies that I'm familiar with have a requirement for 2 EMT's, one of which must be a seaseoned, experienced provider. And to add to that, I know of several non-profits that require a Paramedic and an EMT to staff one ambulance. Private sector service itemizes services when they bill. So much $ for loading, mileage, oxygen, IV's, IV fluids, individual medication administration, etc. Compare an emergency transport by a non-profit to an emergency transport by a private entity and the private entity will be hundreds of $ higher for the same service.

  • Gilbert Gnarley

    Hmmmm....the Legislature must be comin' to town soon.

  • Dale

    Non-emergency transports are a cash cow for county EMS units that they don't want to lose. Costs at every level in the medical field are out of control and breaking the back of this country. Stick to your plan Governor.