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Ambulance company treats congressman to an earful

Emergency Medical Technician Erica Cutrona talks with Virginia Rep. Rob Wittman (R-1st) during a ride to the MWH Emergency & Outpatient Center in Spotsylvania County Thursday. (ROBERT A. MARTIN / THE FREE LANCE-STAR)

Rep. Rob Wittman went by ambulance to not one, but three area emergency rooms on Thursday.

Not to worry. He’s fine.

Wittman, a Republican who lives in Montross and represents Virginia’s 1st District, was riding courtesy of LifeCare Medical Transports Inc., which wants his help extending a critical funding source: Medicare payments for ambulance transport.

“We invited him here because the Medicare [Ambulance Access Act] expires in January,” LifeCare president Kevin Dillard said prior to a roundtable meeting with employees followed by a tour of the business, and visits to Stafford Hospital and Mary Washington Hospital emergency rooms and Spotsylvania Regional Medical Center.

“We’ve already seen two cuts in funding—a 2 percent reduction a couple years ago, and another 2 percent this year,” Dillard said.

“So we wanted to get across the message that if we’re going to provide the level of service that everybody expects—having [vehicles] available when they call, and the equipment needed for lifesaving—they’ve got to fund us properly.”

LifeCare, headquartered in Stafford County, is among the largest private ambulance companies in Virginia, with 14 locations across the state and 70 ambulances. The company has more than 350 employees.

Dillard also is president of the Rappahannock EMS Council.

For more than a decade, private ambulance services have been depending on add-ons to Medicare reimbursements for patient transport to hospitals, doctors’ offices, dialysis and other destinations. The idea was to close the gap between the reimbursement amount and the actual cost of providing the service.

But the bonus ends in January unless Congress extends it, as it has done each year since 2002. Senate Bill 1403, filed by Sen. Charles Schumer, D–N.Y., would extend existing Medicare reimbursement rates for ambulance transport until 2019.

Meanwhile, the House and Senate are also looking at changes to the tax code to overhaul the way Medicare reimbursement payments are structured.

Dillard says about half of patients using LifeCare ambulances are covered by Medicare. Medicaid and private funding account for the rest.

“And there’s a significant amount of people with no [health] insurance, who can’t pay their bill at all,” Dillard said. “So it’s complicated.”

He says if private carriers aren’t adequately funded, the impact also hits taxpayer-funded county and city services, and ultimately, taxpayers.

If private suppliers have to cut back, localities that handle 911 transport calls have to pick up the slack.

During the sit-down with employees, Dan Wildman, LifeCare’s vice-president and co-owner, said other funding issues loom on the horizon.

For example, in October, “We’re facing a 10 percent cut on transport of dialysis patients,” Wildman said. “Dialysis is a significant part of our business.”

Joey King, LifeCare’s vice president of operations, said the company has been working with the American Ambulance Association and Virginia Ambulance Association on getting the word out about the pending end of the transportation reimbursements.

Providers across the country would be affected if there’s no extension, King said.

Wittman told the group he understands their concern, at a time when cost of all federal programs is under tight scrutiny by lawmakers.

“It’s critical today to look at health care reform from top to bottom,” Wittman said. “And in the critical job you do in medical transport, we need to make sure that the reimbursements that come from Medicare” and state-funded Medicaid “are there so you can do your job.”

With Medicare, “I want to make sure that we’re doing the proper things with the entire program,” he said, noting that the ambulance reimbursements are tied to federal health reform.

“So, we’re looking closely at how those pieces fit together,” Wittman said, with the focus being a sustainable, long-term plan.

On the trip to Stafford Hospital, Wittman sat in the back of an ambulance with LifeCare technician Althea Kidd, who told him that patient care goes far beyond medicine.

“We get to know them,” she said. “We talk to them.”

Wittman nodded, saying, “A lot of people don’t grasp what you do until they or people they love” wind up on a white gurney in the back, “or until they get the bill.”

Rusty Dennen: 540/374-5431