[Congressional Record Volume 147, Number 178 (Thursday, December 20, 2001)]
[Extensions of Remarks]
[Pages E2344-E2345]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        MEDICAL RURAL AMBULANCE SERVICE IMPROVEMENT ACT OF 2001

                                 ______
                                 

                          HON. JOHN P. MURTHA

                            of pennsylvania

                    in the house of representatives

                      Wednesday, December 19, 2001

  Mr. MURTHA. Mr. Speaker, across America, Americans have come to 
expect and rely on our health care system, especially, emergency 
ambulance service. All to often, for many of us, our first exposure to 
health care is the local EMS unit that responds to a call for help. 
Unfortunately, for millions of Americans living in a rural setting, 
this cornerstone of medical care is on the verge of collapse.
  I, for one, am a strong believer in the importance and the necessity 
of maintaining a strong effective EMS component within our health care 
system. The question that we must answer, as we debate health care, is, 
how prepared do we want and expect our

[[Page E2345]]

health care system to be. In an emergency, at that critical moment, the 
EMS unit is that critical link to our health care system that makes the 
difference between life and death.
  Unfortunately, be it ground or air, EMS for communities throughout 
America is under enormous financial pressure. For many rural 
communities, EMS is in jeopardy of collapse. Typically, rural EMS is a 
small one or two unit service, staffed by volunteers, not affiliated 
with a hospital or medical facility, that responds to 300 to 500 calls 
per year within a large radius (37 miles average) who's greatest danger 
to its existence comes from Medicare. In a growing number of instances, 
unrealistic and unresponsive Medicare reimbursement fee schedules have 
done more to erode EMS in America than any other threat to medical care 
in this country. Because Medicare fees fail to accurately define or 
reflect the rural medical environment, EMS is facing grave danger of 
being put out of business by fee schedules that fall to recognize and 
reflect the actual costs confronting rural ambulance/EMS service.
  Therefore, I am introducing the ``Medical Rural Ambulance Service 
Improvement Act of 2001''. This legislation will increase by 20 percent 
the payment under the Medicare program for ambulance services furnished 
to Medicare beneficiaries in rural areas, require CMS to define rural 
areas on population density by postal zip codes, increase mileage rates 
for the first 50 miles and require the use of most recent data by CMS 
in determining payment adjustments.
  For rural ambulance and EMS, the majority of their revenue comes from 
Medicare reimbursements. Yet existing Medicare fee schedules are not 
accurate, nor do they reflect real-world costs confronting rural 
services. Due to their low-volume of calls and transfers, rural EMS 
providers will remain the hardest hit under CMS' fee schedules unless 
decisive and corrective action takes place now.
  Timely and accurate reimbursement and fee schedules for ambulance/EMS 
services will be critical to seeing that rural America continues to 
receive emergency medical services. Citing financial loss as the number 
one contributing factor for services closing down, the ``Medical Rural 
Ambulance Service Improvement Act of 2001'' will level the playing 
field for rural EMS.
  Good health requires an effective and thorough health care system. We 
all have something to lose by not putting a halt to the erosion of EMS 
care in rural America. Therefore I am calling on all Members to join 
with me and sponsor passage of this important and critical piece of 
health legislation.

                          ____________________