[Congressional Record (Bound Edition), Volume 147 (2001), Part 9]
[Extensions of Remarks]
[Pages 12192-12193]
[From the U.S. Government Publishing Office, www.gpo.gov]



INTRODUCTORY COMMENTS: ``MEDICARE RURAL AMBULANCE SERVICE EQUITY ACT OF 
                                 2001''

                                 ______
                                 

                          HON. JOHN P. MURTHA

                            of pennsylvania

                    in the house of representatives

                        Wednesday, June 27, 2001

  Mr. MURTHA. Mr. Speaker, from an urban setting to the furthest 
reaches of rural America, Americans have come to expect and rely on 
health care that includes emergency ambulance service. Unfortunately, 
for many of us, our first exposure to medical care is, all too often, 
the EMS unit that responds to our call for help. Yet, for millions of 
Americans living in rural America this cornerstone of medical care is 
in danger of collapse.
  Typically, rural EMS is a small one or two unit service, staffed by 
volunteers, not affiliated with a major medical facility, that responds 
to 350 to 500 calls per year within a large radius (37 miles average) 
who's greatest danger to its existence comes from Medicare.
  From the Pacific Northwest to the Florida panhandle to the rural 
setting of Pennsylvania,

[[Page 12193]]

an unrealistic and unresponsive Medicare fee schedule has done more to 
erode emergency medical service in rural America than any other threat 
to medical care in this country. Because Medicare fees fail to 
accurately reflect the rural medical environment, rural EMS is facing 
grave danger of being put out of business by a fee schedule that fails 
to recognize the actual costs confronting rural ambulance/EMS service.
  Therefore, I am introducing the ``Medicare Rural Ambulance Service 
Equity Act of 2001,'' to increase by 20 percent the payment under the 
Medicare program for ambulance services furnished to Medicare 
beneficiaries in rural areas.
  For rural ambulance/EMS, the majority of their revenue (60 to 70 
percent) comes via Medicare reimbursements. Unfortunately, existing 
reimbursement fee schedules do not accurately reflect real-world 
circumstances confronting rural service. New Center for Medicaid and 
Medicare Services (CMS) (previously referred to as HCFA) fee schedules, 
anticipated to go into effect by early fall, will not adequately 
correct the problem. Rural ambulance/EMS providers in every State will 
remain the hardest hit under the new fee schedule due to their low-
volume of calls and transfers each year.
  Timely and accurate reimbursement schedules for ambulance/EMS 
services that accurately reflects real-world costs and expenses are 
critical to the rural providers' ability to continue to operate. 
Passage of the ``Medicare Rural Ambulance Service Equity Act of 2001'' 
will level the playing field for rural emergency medical service.
  All too often we are seeing rural EMS providers go out of business--
citing financial loss. The primary contributing factor they cite for 
their loss--an unrealistic and unresponsive Medicare reimbursement fee 
schedule.
  Recently the town council in Avonmore, Pennsylvania voted to close 
their ambulance/EMS after 27 years. Their reason, they couldn't afford 
to remain in business. Why, because with nearly 68 percent of their 
revenues from Medicare reimbursements they couldn't afford any longer 
to maintain the service for the community--A sad but all too true 
reality confronting rural medical care in America.
  The ``Medical Rural Ambulance Service Equity Act of 2001'' is not the 
panacea for the growing shortcomings of health care in America, but its 
20 percent increase in reimbursement will stop the hemorrhaging that we 
are experiencing in rural emergency medical service.
  We all have something to lose by not putting a halt to the erosion of 
rural EMS. Therefore, I call on all Members of Congress to immediately 
pass this important piece of health legislation.

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