Miller, Colleagues Send Letter to Protect Access to Ground Ambulance Services

Washington, D.C. - Today, Congresswoman Carol Miller (R-WV) and Representatives Claudia Tenney (R-NY), Tracey Mann (R-KS), Gregory Steube (R-FL), Adrian Smith (R-NE), Bruce Westerman (R-AR), David Kustoff (R-TN), Riley Moore (R-WV), Mike Carey (R-OH), Troy Balderson (R-OH), Mike Kelly (R-PA), Brian Fitzpatrick (R-PA), Brad Finstad (R-MN), and Randy Feenstra (R-IA) sent a letter to the Department of Health and Human Services, Centers for Medicare & Medicaid Services, Health Resources & Services Administration, and U.S. Department of Agriculture to protect access to ground ambulance services provided to patients in rural areas by promptly updating geographic adjustments to the Medicare Ambulance Fee Schedule to ensure correct payment for rural and super-rural communities.

Click HERE for the full letter.

On the lawmakers' concern regarding the need to preserve and increase access to ambulance services:

The need to preserve and increase access to ambulance services is clear when considering 4.5 million Americans that live in ambulance deserts - areas located 25 minutes or more away from an ambulance station. Unsurprisingly, 2.3 million of those individuals live in rural counties and 84 percent of rural counties have at least one ambulance desert. Despite the best efforts of rural ambulance providers, rural patients in ambulance deserts often experience care delays that can devastate a person's health and can lead to death. For example, in the event of a stroke, a patient loses 1.9 million neurons each minute during which a stroke is untreated. Meanwhile, nearly 600 patients per 100,000 in rural America suffer from strokes - a rate nearly 20 percent higher than that of urban America. Limited availability of ambulance services in ambulance deserts results in care delays for all patients, and actively endangers the life of stroke patients or others suffering from significant emergencies.

On the importance of promptly updating ZIP codes to improve the accuracy of identifying underserved areas and ensure the correct providers are benefiting from Medicare ground-ambulance add-on payments:

Congressionally-mandated Medicare ground ambulance add-on payments help ensure adequate funding to ambulance providers in rural areas, but require timely and accurate data inputs to ensure the correct providers are benefiting from this investment. Unfortunately, HRSA and USDA have not modified the ZIP codes used to establish geographic designations in the AFS since the CY 2015 PFS final rule - thereby limiting CMS's ability to pay add-on payments reflective of the geographies that ambulance providers serve. In fact, an analysis of 2020 U.S. Census data estimates that with updated information, 1,490 ZIP codes would shift from rural to super rural status, and 782 would move from urban to rural status, granting them correct reimbursement to preserve patient access to care. This makes updating the ZIP codes a critical and necessary step to improve the accuracy of identifying these underserved areas to ensure patient access to emergency services.

We thank you for your consideration of this request and hope to work together to update this information. Our rural communities deserve equitable ambulance access, and updating the geographic designations in the AFS would ensure rural patients are not left behind, especially during medical emergencies.

Background:

In March of this year, Congresswoman Miller and six of her colleagues introduced the Protecting Access to Ground Ambulance Medical Services Act to ensure rural and remote communities maintain access to critical emergency services.

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