Lawmakers request expansion of fire, EMS reimbursements

The bipartisan group of House representatives is calling for agencies to receive reimbursements for treatment-in-place responses and telehealth use


By Laura French

WASHINGTON — A bipartisan group of U.S. House representatives has issued a letter calling for the expansion of COVID-19-related reimbursements for fire and EMS departments. 

The group of 36 lawmakers, led by Rep. Cindy Axne (D-Iowa), Rep. French Hill (R-Ark.) and Rep. John Larson (D-Conn.), sent the letter to Department of Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma requesting that agencies be reimbursed for treatment-in-place responses and telemedicine use during the pandemic, in addition to the reimbursements received for treating patients who are transported. 

A bipartisan group of U.S. House representatives has issued a letter to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services calling for the expansion of reimbursements for fire and EMS departments to include treatment-in-place responses and telemedicine use. (Photo/U.S. House of Representatives)
A bipartisan group of U.S. House representatives has issued a letter to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services calling for the expansion of reimbursements for fire and EMS departments to include treatment-in-place responses and telemedicine use. (Photo/U.S. House of Representatives)

"While fire departments and EMS agencies have long struggled with incomplete federal reimbursements, the problem is becoming worse as the spread of COVID-19 is driving greater numbers of patients to refuse ambulance transportation to hospitals because they fear exposure to the SARS-CoV-2 virus," the letter states. "Because of CMS' reimbursement policies, this large reduction in ambulance transports is placing an enormous financial burden on fire departments and EMS agencies who have to maintain required levels of service and minimum response times while receiving significantly decreased reimbursements." 

The lawmakers pointed out that CMS allows for treatment-in-place reimbursements under the Emergency Triage, Treat, and Transports (ET3) program, and suggested using the ET3 concept as a precedent for fairer EMS and fire department reimbursements during the COVID-19 crisis. 

"EMS agencies providing 'treatment in place' are instrumental in preserving precious healthcare resources needed for the most severely ill patients, and have saved the healthcare system a great deal of money. Amazingly, however, CMS does not reimburse EMS agencies for this care, and this needs to change," NAEMT President Matt Zavadsky said in a statement, according to a press release from the office of Rep. Axne.

"The current federal reimbursement mechanism is woefully antiquated and fails to keep pace with the ability of fire departments to provide the most medically appropriate care to patients. Both patients and fire departments benefit from when patients are given the most medically appropriate treatment," IAFC President Gary Ludwig said in a statement. "Reimbursing fire departments for providing patient care on-scene will yield significant savings to the healthcare system and ensure more firefighters and EMS personnel are available to respond to the next emergency."

Read the full letter below:

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