U.S. Reps Call for Reimbursements for Treatment in Place

07/01/2020
EMS World

Today, Rep. Cindy Axne (IA-03), Rep. French Hill (AR-02), and Rep. John Larson (CT-01) led a bipartisan letter seeking fair reimbursements for firefighters, emergency medical services (EMS), and other medical first responders. Firefighters and EMS have been called upon with increasing frequency during the coronavirus (COVID-19) crisis to help keep American communities healthy and safe. 

Currently, firefighters and medical first responders are only repaid for supplies and services they provide if they transport a patient to the hospital. They are not reimbursed for these services when provided on scene. Additionally, even though many ambulances have the technology to facilitate emergency telehealth consultations, lack of clear and consistent reimbursement has prevented this service from being fully utilized.

In their bipartisan letter to the U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS), the members urge the agencies to expand reimbursements to include care provided on the scene of an emergency, known as ‘treatment in place’ (TIP), and provide direct reimbursement for ambulance telehealth use. 

“Our fire departments and EMS first responders have gone above and beyond to respond to the COVID-19 public health emergency. As health care providers limited face-to-face medical visits and patients voiced concerns about in-person care, our first responders stepped up to continue to deliver emergency care and response for the illnesses and injuries that our communities face,” said Rep. Axne. “Just as our firefighters and EMTs are here for us, we need to ensure federal health agencies are here for them. Even if a patient isn’t transported to a hospital, or if the care is provided using telehealth, CMS reimbursements should still be available for those agencies who are helping our citizens – especially with looming budget shortfalls at our state and municipal levels.”

“First responders across the nation have provided extraordinary service during the current public health crisis, but increasingly they are being put in a difficult position during emergencies:  take someone to the hospital no matter what, overburdening an already burdened emergency health care system, or run the risk of not being reimbursed for their services,” said Rep. Hill. “Fire fighters and EMS personnel should not be faced with this choice in a serious situation, which is why I am proud to lead this effort with 36 Members of Congress to get resolution and let our first responders return their full focus to keeping their community healthy.”

"The COVID-19 pandemic had rapidly changed our health care landscape. Our first responders and particularly EMS personnel have stepped up and took on a bigger share of emergency pre-hospital and tele health care during this pandemic,” said Rep. Larson. “They bravely serve on the front lines and answer every emergency call. I'm proud to co-lead a letter with Reps. Axne, and Hill urging the Center for Medicare and Medicaid Services to reimburse EMS for their critical service in our communities.”

The members highlight the risk that COVID-19 already poses to state and municipal budgets, potentially threatening budget cuts and layoffs for fire departments and emergency response if current reimbursement structures are not updated.

The letter was signed by over thirty House members from both sides of the aisle: Reps. Don Bacon (NE-02),Anthony Brindisi (NY-22), Susan W. Brooks (IN-05), Cheri Bustos (IL-17),Andre Carson (IN-07), Ed Case (HI-01), Angie Craig (MN-02), Jason Crow (CO-06), Sharice Davids (KS-03), Lloyd Doggett (TX-35), Jeff Duncan (SC-03), Abby Finkenauer (IA-01), Brian Fitzpatrick (PA-08), Anthony Gonzalez (OH-16), Jahana Hayes (CT-05), Eleanor Holmes Norton (DC-AL), Sheila Jackson Lee (TX-18), Conor Lamb (PA-17), Doug Lamborn (CO-05), Al Lawson (FL-05), Susie Lee (NV-03), Dave Loebsack (IA-02), Roger Marshall (KS-01), Grace Napolitano (CA-32),Joe Neguse (CO-02), Tom O'Halleran (AZ-01), Max Rose (NY-11), Terri Sewell (AL-07), Paul Tonko (NY-20),Bennie G. Thompson (MS-02), Xochi Torres Small (NM-02), Marc Veasey (TX-33), and Jennifer Wexton (VA-10).

The member’s letter was sent today with the support of the International Association of Fire Chiefs (IAFC), International Association of Fire Fighters (IAFF), National Association of EMTs, National Association of EMTS (NAEMT), National Volunteer Fire Council, Congressional Fire Service Institute, and Association of Air Medical Services.

“The IAFC is grateful for Rep. Axne’s work to highlight fire departments’ urgent need for reimbursement when caring for patients on-scene and not transporting them to the hospital. 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,” said Fire Chief Gary Ludwig, IAFC President and Chairman of the Board. “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. The IAFC looks forward to continuing to work with Rep. Axne to ensure fire departments are properly reimbursed for the medical care that they provide to their communities.”

“Fire fighters and emergency medical personnel are the first link in the public health system, providing pre-hospital treatment and care in patients’ homes and businesses.  This important role has been highlighted more than ever during the COVID-19 pandemic,” said Harold Schaitberger, General President International Association of Fire Fighters. “Unfortunately, antiquated rules prevent reimbursement for emergency calls if a patient is not transported to a hospital.  Reimbursing fire and EMS departments for treatment in place and telehealth services will ensure patients receive the care they need while reducing load on hospitals. The IAFF joins Representatives Axne, Hill and Larson in support of these important updates.”

“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,” said Matt Zavadsky, MS-HSA, President of the NationalAssociation of Emergency Medical Technicians. “Amazingly, however, CMS does not reimburse EMS agencies for this care, and this needs to change.”