ROCHESTER, N.Y. (WROC) – Local lawmakers and EMS agencies continue the push for Governor Kathy Hochul’s signature on a bill that would regulate how first responders are paid for emergency care services.
The Direct Pay Bill would require health insurance plans to immediately reimburse ambulance providers across New York State when transporting a patient out of network.
EMS companies are hoping the legislation is passed sooner than later to continue timely care and minimize the financial burden.
“Essentially, a lot of checks get sent to the patient. As a result, those checks don’t make it to the ambulance company that provided the services,” said Frank Manzo, chief and CEO of CHS Mobile Integrated Health Care in Henrietta.
The bill has unanimously passed both the Senate and Assembly.
For local companies like CHS, Manzo says it has resulted in hundreds of thousands of dollars lost each year.
“We specifically lose about $500,000 a year in lost or kept checks. There’s also the problem of people intentionally keeping checks because it is written out to them and unfortunately, we default to a collection agency at some point. Now, we’re chasing people that are essentially creating insurance fraud and keeping money that is not theirs. We have very little power over them to collect that money,” said Manzo.
Health insurance companies are pushing back as the bill, if passed, would regulate cost control for insurers.
Lawmakers like Assemblymember Harry Bronson share the concern with emergency care providers.
“What happens is we then are asking our volunteer ambulance services to become a collections agency. That takes time and takes money and distracts them for the job we’re asking them to do, which is to provide the medical services to keep our loved ones alive and get them to hospitals where they can get essential care. It’s a very simple bill,” said Bronson, “We’re just asking the insurance carriers to pay the ambulance services directly.”
If the legislation is vetoed by the governor, ambulance providers say there could be a ripple effect on response times.
“At CHS, we’re very fortunate with the towns we work with. But, we’re very frequently having to go out and help our neighbors and occasionally, they help us. As a result, we’re really reliant on each other. So, our neighbors and ourselves being financially sound is critical in response times remaining the way they are and we can get ambulances to people who need them in a timely manner,” said Manzo.
A spokesperson from the governor’s office tells News 8 the legislation will be reviewed.
Gov. Hochul has a 10-day window from the time the bill is called to pass or veto it. If there is no action taken, the legislation would take effect in January 2025.