The Maine Ambulance Association attends all key Maine EMS meetings, such as the Board of EMS, the Medical Direction and Practices Board, and various sub committees. The MAA also closely monitors legislative activity and maintains a solid working relationship with Legislative leaders and members.
During the 129th Legislature (2019 – 2020), the MAA sought and advocated for landmark legislation relating to reimbursement. Most notably, effective 1/1/20, MaineCare must reimburse ambulance services at no less than the average Medicare rate. Prior to this change, the reimbursement was set at only 65% of Medicare. This change alone resulted in ~ $10 million annually for ambulance services.
The MAA was also very active in LD 2105, which focused on “surprise” billing for emergencies. This bill as presented would have had a significant impact on ambulance services by forcing them to go through an extensive appeal process if an insurance carrier denied a claim. As a direct result of our input, the legislature did several things:
- Provided an exemption for ambulance services until October 31, 2021, and unless there is a contract in place, requires insurance carriers to pay what they are billed from an ambulance service and send the payment directly to the ambulance service.
- Established a committee that includes the MAA to review reimbursement rates and issues affecting contracting between insurance carriers and ambulance services.
- Require a report to be submitted no later than February 1, 2021, and allow legislation to be introduced subsequent to that report.
Recently, the MAA advocated for its members with an insurance carrier who suddenly denied a large number of claims. As a result, that carrier modified its review process, reviewed and paid several previously denied claims (estimated to be greater than $1 million), and set up a webinar for ambulance providers and the insurance carrier to learn how to efficiently file claims.