When the Legislature finally produced a measure to prevent ambulance companies from gouging out-of-network patients and their insurers, it set a limit of 300 percent of the federal Medicare reimbursement rate or the ambulance’s regular fee, whichever is lower. This is a ceiling that might function more like a floor, pushing ambulance firms to raise their rates to 300 percent of Medicare. It’s a bad idea.
Price-gouging by ambulance services, including those run by municipalities, was always a disreputable exercise, preying on people who suffer emergency illnesses or injuries. And when insurers decided to fight back by reimbursing patients a set amount, rather than pay whatever the ambulance demanded, they, too, threw patients under the wheels: Ambulances expected the patients to make up the difference between the insurers’ rate and the ambulance’s. Few situations better illustrate patients’ frustrations with the health care system.
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So the unwanted task of deciding on an appropriate level of reimbursement fell to the state. And it should surprise no one that both insurers and ambulance services are lobbying for the best possible deal, while grumbling about government interference. Fire departments and other municipal offices that operate ambulances are hoping their friends in the Legislature can deliver a generous fee.
The federal Medicare rate isn’t usually high enough to cover all the ambulance costs, so the Legislature is right to go above it. But 300 percent is too high. Patrick should veto the bill and ask the House and Senate to send it back to him with a lower price ceiling.