CHARLESTON, W.Va. -- A proposed change to the way Medicaid patients are transported to doctor's appointments and other non-emergency medical appointments would hurt local emergency medical services agencies, representatives say.
The state Bureau for Medical Services plans to accept bids from agencies interested in managing all of the non-emergency medical transportation for Medicaid patients. Currently, local EMS agencies and private ambulance companies handle those non-emergency calls within their areas.
Using a brokerage system was one of nearly 80 cost-saving recommendations that Pennsylvania-based Public Works LLC made in its state-commissioned audit of the Department of Health and Human Resources. In the audit, released in April, the agency wrote that the Bureau for Medical Services could save $5.2 million in one year and $26 million over five years using a broker.
Representatives from local EMS agencies, though, say the revenue they get from non-emergency runs help offset the costs of emergency calls. They're concerned that a broker may cut the rates they get for non-emergency transportation or bring in other agencies that can do the work cheaper.
In Kanawha County, rural areas like Clendenin may not survive without non-emergency medical transportation calls, Joe Lynch, director of the Kanawha County Emergency Ambulance Authority, said.
"Our ambulance system [in Clendenin], if it didn't do non-emergency with emergency we would never afford to pay for it," Lynch said. "And it's subsidized by a levy, too, but [EMS agencies] have to do all those all those levels of services so it pays for itself."
More than 60 people, including representatives from EMS agencies around the state, attended a pre-bid meeting about the brokerage system Thursday afternoon at the Department of Health and Human Resources.
According to the request for proposals from DHHR, the broker would have to have at least three years of experience handling non-medical transportation and have experience in three different states.
EMS representatives say that would rule out any local emergency service provider from West Virginia that might want to apply.
"When you've got someone from out of state that totally has no skin in the game... they're going to take that from those ... EMS providers and [EMS providers] are going to go out of business," Lynch said. "Part of that safety net for the state is going to be gone."
Ambulance agencies that don't do emergency calls can do non-emergency calls at a lower cost than the local agencies, Lynch said.
"We call it cream-skimming because [what] they do is they go home on holidays, they don't go to the ballgames because none of that's paid for," he said. "We're on standby because of you and the public. When brokerages come in here and carve out that level of funding, it's going to be disastrous to a lot of the EMS agencies."
Trish Watson, director of Lincoln County EMS, called the brokerage plan "worse than a bad idea." DHHR officials have not thought about the impact to local EMS agencies, she said.