Consumer Alert: EMS providers urge Gov. Hochul to sign a bill allowing for direct payment
ROCHESTER, N.Y. — One of the most common consumer complaints News10NBC gets involves surprise bills from an ambulance company. The reason for those bills can be blamed in part on the State of New York.
It involves the State’s mandate concerning how your out-of-network provider gets paid. Because insurers don’t have to send payment directly to the ambulance service, you may get a bill for the full amount — which causes a lot of confusion and a long delay in ambulance services getting paid. A bill sitting on the governor’s desk aims to change that.
When you’re facing a health crisis, you expect an ambulance to be there when you call. But across the state, ambulance services are facing financial crises making it difficult to provide life-saving services.
“It can delay the time the person might wait to receive care,” said Jonathan Smith, chief of the Pittsford Volunteer Fire Department and chair of the Monroe County Chief’s Association. “Any time that we’re lacking resources, we’re relying on our neighbors to help fill that gap.”
Here’s the problem with that: All their neighboring ambulance services are in a crisis as well.
An investigation in May by News10NBC’s Jennifer Lewke revealed that over the last decade, 237 ambulance services across New York state have closed, merged, or been taken over.
The problem, in part, is the way they’re paid. in New York State, Insurance companies are not obligated to pay out-of-network providers directly, and most ambulance companies are out of network.
“And if they’re out of network, the payment that should go directly to the ambulance service goes to the patient,” said Assemblyman Harry Bronson, representative of New York’s 138th District.
And often patients keep the check, forcing ambulance companies to act as de facto collection agencies. That’s why all the politicians at a Thursday press conference as well as every member of the assembly and senate voted for legislation that would mandate that insurers pay ambulance services directly.
“I don’t care what political environment you’re in. Unanimous approval of anything right now is a big deal,” said Smith jokingly.
An equally big deal is the assurance that ambulance companies get reimbursed. They’ve not been designated as essential services. So there’s no mandate to fund them with taxpayer dollars.
“It’s unlike law enforcement or the fire service that is fully funded. We work with donations to make that gap. We work, in some cases, with local communities to make that subsidy,” said Smith.
Now, the bill waits only for the governor’s signature to become law. Smith’s message to her was clear.
“I know there are press conferences going on around the state,” said Smith. “It’s a common issue. Gosh, it’s zero dollars, unanimous consent. It’s an easy win. We’re just looking for her to give us her support.”
It’s important to note, the bill does not affect how much the ambulance company is paid.
It only mandates that your insurer pays the ambulance company directly.
The governor has 10 days to sign or veto the bill. If she does nothing, the bill becomes law.