A move by the U.S. Veterans Administration (VA) to begin reimbursing non-contract ambulance and air ambulance transportation at rates significantly below costs is getting heavy pushback from federal legislators and providers. The new rule covering reimbursement would take effect this February. Industry critics are charging that the move would force providers to downsize operations and reduce hours of availability while compromising the ability of veterans, particularly in rural areas, to receive prompt medical transport.
The VA currently pays for the actual costs of such medical transports. However, Congress has granted the VA the authority to pay the “lesser actual charge for the transportation or the Medicare Fee Schedule (MFS) amount unless the [VA] secretary has entered into a contract for that transportation with the provider.” (38 U.S.C. section 111(b)(3)(C)) This will allow the VA to impose the MFS payment schedule, which is invariably and significantly below actual costs, the industry charged in a recent suit filed against the VA with the U.S. Court of Appeals on October 26, 2023. It was filed by the Metropolitan Area EMS Authority, including Texas-based MedStar Mobile Healthcare and Pennsylvania-based Valley Ambulance Authority, Quaker Valley Ambulance Authority, and Amed. MedStar maintains that the new rule would cost it $1.4 million annually.
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