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Stakeholder group suggests removing "Ambulance" from state's transportation brokerage model

Wednesday, October 18, 2017 6:56 AM | PAAW Administrator (Administrator)

Advocacy

Members of the Transportation Advisory Council, which includes the Professional Ambulance Association of Wisconsin, recently authored a joint letter to the Wisconsin Department of Health (DHS) with several recommendations to improve the program as it moves forward.  The transportation contract is issued by the state and will be bid out sometime in 2018.

One recommendation offered in the letter is to remove non-emergency "ambulance" from covered services in the upcoming bid.  >> Click to review letter.

Since 2011, non-emergency ambulance transportation was first included in the broker model.  Broker services began with Logisticare and later changed to MTM, who is the current broker management company.   Under the model, ambulance services are required to get an authorization number prior to transporting a non-emergency patent.

The broker model hasn't been kind to ambulance services with brokers often short paying bills, delaying payment for months or not paying invoices at all - even after patient transportation services were provided.  It is estimated that over one-million dollars has been lost to unpaid bills since inception of the program. 

When a covered beneficiary under the Medicaid program summons an ambulance and it is deemed an emergency, then the transporting ambulance service is outside the broker model and can bill DHS directly as a covered service.  That's how is was handled too for non-emergency ambulance services, until the broker model was introduced by the state as a cost saving and Medicaid program management initiative.
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