Munhall Area Prehospital Services is living payroll to payroll.
“If we were to have four to five bad months, it would finish us,” Emergency Medical Services Manager Richard McClean said.
The nonprofit ambulance service struggles because of the high number of uninsured people living in its Munhall-Homestead-West Homestead service area, but also because of low reimbursements from Medicare and the discounted rates it must accept from Highmark Inc. if it is to get direct payments from the insurer, McClean says.
Several ambulance services say they are hurting — and might need to cut services or dissolve — because of a complicated insurance reimbursement system that pays them far below their rising costs. People needing ambulances might have fewer outfits serving them, leading to longer wait times, said Knox Walk, the EMS director for Allegheny County.
“Everything else is going up, and we’re being paid less,” said Bryan Kircher, director of Ross/West View EMS. “It’s becoming more difficult to balance the budget and (maintain) that same level of service.”
Making matters worse, Highmark and other insurers refuse to reimburse the ambulance companies directly unless they sign contracts accepting steep discounts for services. The checks instead go to patients, many of whom pocket the money, said William Hess, chief of Monessen-based Mon Valley EMS.
“If you don’t contract with them, 90 percent of the time they won’t send the checks to us,” he said.
The Ambulance Association of Pennsylvania, which represents about 200 ambulance companies, and 16 individual companies sued Highmark and six other insurers in 2010, arguing the insurers conspired to force them into discounts. A federal judge dismissed the lawsuit in June.
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Ambulance squads hurt by reimbursements that don’t meet costs – Pittsburgh Tribune-Review.