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Reimbursements for EMS Service Approved by PA Committee

December 15, 2017
FROM:     Don Konkle, Executive Director, PFESI
RE:         Reimbursements for EMS Service Approved by PA Committee

The Senate Banking & Insurance Committee today (December 13) approved legislation, Senate Bill 1003, that would require insurance companies and Medicaid to reimburse emergency medical services agencies for services provided even when transport to a hospital does not take place, according to Committee Chairman Senator Don White (R-Indiana).

Senator White said Senate Bill 1003, a measure he introduced, would ensure that EMS agencies are properly reimbursed for their services when called out to provide care. Currently, insurance companies and Medicaid are only required to reimburse EMS organizations for those services when they include transportation to a hospital.

"There are cases where crews respond to a scene to provide care and treatment, but transportation is unnecessary or refused. Not every case requires hospital treatment or in some cases the patient is reluctant to seek further treatment," said Senator White. "That means that these responders can be stiffed for payment by insurance companies and that's just not fair. There are costs incurred and man hours spent by these organizations. Senate Bill 1003 will ensure those organizations are properly reimbursed for their services."

The committee also approved Senate Bill 637, a measure introduced by Senator White that would establish a Pharmaceutical Transparency Commission to review drug prices in Pennsylvania and require pharmaceutical companies to disclose information about their pricing.

"Healthcare costs overall are out of control and pharmaceuticals are a big part of that. Given the magnitude of the industry, there is a great need for transparency and accountability," said Senator White. "Prescription medications have certainly improved health care and they may even reduce the aggregate costs of health care. However, there is little information available as to why they cost so much. Nothing holds down costs better than an informed consumer, which is the goal behind the Pharmaceutical Transparency Commission."

The Commission would be funded through an annual assessment on pharmaceutical manufacturers. It would consist of the Insurance Commissioner and the Secretaries of Health and Human Services, a pharmacist designated by the Pennsylvania Pharmacist Association, a consumer advocate designated by the Leukemia and Lymphoma Society, a physician designated by the Pennsylvania Medical Society and an insurance producer representative designated by the Pennsylvania Association of Health Underwriters.

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