Doug Mastriano is pictured speaking to a group of students in Harrisburg in November.

Three Republican Senators want to allow EMS companies to receive payment when someone is treated but not taken to the hospital.

State Sen. Doug Mastriano, R-Chambersburg, is circulating a co-sponsorship memorandum for legislation he is drafting, with support from Sens. Michele Brooks, who formerly represented part of Warren County in the Senate, and Lisa Baker to require proper Medicaid reimbursement for EMS calls in which treatment is provided but the patient is not transported to a hospital.

“It is important our ambulance companies, many of which are struggling financially, are properly reimbursed for the time, supplies, equipment and life-saving expertise they deliver to our constituents, regardless of whether the end result is a trip to the hospital,” Mastriano wrote in his co-sponsorship memorandum.

A 2024 Legislative Budget and Finance Committee (LBFC) report prompted by a 2023 Senate Resolution sponsored by Brooks, and co-sponsored by Sen. Scott Hutchinson, R-Oil City, recommended the change Mastriano is proposing. The report focused on treat, no transport reimbursements found that over four years from 2019 through 2022, the average amount billed by EMS agencies for treat, no transport calls ranged between $287 and $375. During that same four-year combined timeframe, EMS agencies were only reimbursed at average rates between $53 and $179, or 16.1% to 47.9% of the average amount billed. The report found that while treat, no transport is often associated with drug overdoses and naloxone administration, from 2019 through 2022, only between 1.9% and 2.7% of treat, no transport calls were designated as substance abuse related.

Mastriano said the issue of reasonable cost is complex for EMS agencies. Each agency has a cost of readiness, a fixed expense to staff EMS personnel ready to respond at any moment with supplies and lifesaving equipment. Call volume and inconsistent reimbursement rates and payments also impact the cost or readiness. The report reviewed 14 EMS agencies’ cost per response, finding a range of $246 to $860 (average of $585), which was in line with an estimated statewide average ($550) provided by the Ambulance Association of Pennsylvania.

“The LBFC report specifically recommended that the General Assembly consider implementing a specific state-directed payment or minimum fee for treat, no transport,” Mastriano wrote. “This legislation will do just that by requiring Pennsylvania’s Medicaid program to reimburse EMS services for treat, no transport calls at the same rates required under the provisions of the Fiscal Code amendments approved last year.”