at the forefront of care for Washingtonians.
To advocate for the highest quality patient care through ethical and sound business practices, while advancing the interests of our membership in legislative, educational, regulatory and reimbursement issues.
2020 legislative priorities
Ambulance providers in the State of Washington have not had an increase in their reimbursement rates for Medicaid transports since 2006, when they were granted a 2% rate increase. Meanwhile costs for wages, equipment and training have continued to rise while the reimbursement rate remains unchanged.
A typical Medicaid transport in the State of Washington pays approximately $135 per transport, one of the lowest state reimbursement rates in the United States.
Currently, ambulance reimbursement rates are so low that the service delivery system is under extreme stress. Providers in many jurisdictions are under financial pressures and unable to cover the costs necessary to run a robust system with short response times.
In 2016 the Washington State Ambulance Association asked for a review of the reimbursement rates for ambulance transports and a determination was made by the Washington Health Care Authority that the rates for ambulance transports were too low. The HCA found that the “ambulance rates do not provide adequate compensation for the services required.”
We request a rate increase to bring Ambulance transports up to the level of Medicare reimbursement rates in the State of Washington. Medicare reimburses approximately $265 per transport in the State of Washington as opposed to the $135 paid for Medicaid.
quality assurance fee
Creating a Quality Assurance Fee that will provide an increased reimbursement rate for Medicaid resulting in a stronger EMS system.
In the State of Washington, a Quality Assurance Fee has already been instituted to increase the Medicaid reimbursement rates for Medicaid payments to hospitals and nursing homes. The way the program currently works for hospitals, the provider collects a per bed, per night fee against the billings for a stay in the facility. Those fees create a fund managed by the Health Care Authority. The HCA is authorized by the Center for Medicare and Medicaid services to receive a match for those funds as billings are submitted for reimbursement for Medicaid.
A quality assurance fee for ambulance transports would institute a 4% fee, collected and deposited into an ambulance transport fund which would be used to generate a federal match, resulting in higher reimbursement rates for ambulance services.
This fee would have no negative impact on the State General Fund.
medicaid reimbursement increase
REQUESTING THAT MEDICAID REIMBURSEMENT RATE BE INCREASED FOR a stronger EMS system. We request that the State provide a general Medicaid rate increase for Ambulance Transports at a rate of $6.5 million per year - $13 million for the biennium.
The state should provide a general Medicaid rate increase for Ambulance Transports. With approximately 100,000 Medicaid transports per year it would cost approximately $6,500,000 per year to increase Ambulance reimbursements from the Medicaid rate ($135) to the Medicare rate ($265). The Federal government reimburses Medicaid charges for Ambulance services at rates between 50% and 90% of billing costs. With the federal reimbursement rate included it is anticipated that a state appropriation increases of $6,500,000 per year would cover the increased cost to parity with Medicare.
Additionally, cost of labor is directly related to a need for Medicaid reimbursement increase.