Dear Fellow MTANJ Member,
MTANJ members serve their communities with vitally important mobile healthcare and medical transportation every day. As President of your association, it is my honor to work with my fellow board members to advocate for your needs in Trenton.
As you have likely seen on our website (www.medtransnj.org) or member Basecamp email notifications, MTANJ has recently racked up several key victories, including the reinstatement of crossover payments as well as successful legislation to extend the one EMT staffing rule until 1/1/2023.
Now, more than ever, your dues are sustaining measurable progress for our industry! This year, we look to continue our wins as we work toward the following priorities.
Eliminate Copays for Dual Eligible Patients
Medicare Advantage plans have replaced a high percentage of beneficiary’s traditional Medicare plans. Now dual eligible patients (Medicare with Medicaid) beneficiaries also have these $250 deductible/co-pays or more, on each leg of every trip. These patients are economically disadvantaged and without assets. They cannot possibly pay, resulting in what is effectively free service from ambulance providers. This practice is extremely harmful to our economic viability and continued ability to serve our communities.
For example, a dual eligible dialysis patient with a Medicare Advantage plan likely goes to dialysis round trip three times per week— six legs at $250 deductible/co-pay per leg—or $1500 that the ambulance provider never sees each week. These deductibles/co-pays apply to emergency ambulance service as well. MTANJ will seek legislative solutions to eliminate these impossible copays, benefitting both providers and patients.
Raise the Medicaid Emergency Ambulance Rate
The Medicaid Emergency Ambulance Rate (A0429) of $58.00 plus $1.50 per mile has not been increased since 1994 and comes nowhere near close to covering the cost of care. Even Medicare pays us $450.00 plus $8.00 per mile.
The MTANJ has tirelessly advocated for an increase from DHS. We have waited for 27 years and will not wait another. In 2022, the MTANJ board will ramp up advocacy pressure with the goal of attaining sustainable funding for A0429 transports.
The unique needs of bariatric patients—and the additional costs incurred by mobile healthcare providers that serve them—are not presently acknowledged nor reimbursed by insurance carriers. We estimate that the cost to the provider is at least two to six times higher than a non-bariatric ambulance trip due to increased labor costs, supplies, and the remarkably high cost of specialty vehicles outfitted for larger-bodied patients.
For example. electric bariatric stretchers cost about $14,000 each. The units are also equipped with winches, ramps, and various other necessities to transport bariatric patients. Oftentimes, it takes four (4) to ten (10) EMTs to manage these large patients if stairs are involved. This is not reimbursed and certainly not sustainable for our industry.
Bariatric transport has the largest patient injury risk and the most employee injuries, even with the best training and specialized equipment available.
Bariatric wheelchair units are also used daily, and not recognized or reimbursed appropriately, either. The MTANJ board will push for supplemental payments for transporting these special patients, whether by ambulance or MAV.
ModivCare (formerly Logisticare) Broker
All the rates paid to providers by the State of New Jersey’s Medicaid transportation broker fall far below our operational costs. These low rates drive down wages and result in in high employee turnover, due to hard work and low pay. MTANJ will advocate for a floor rate of roughly 10% above our costs.
American Rescue Plan Act (ARPA) Funding
The MTANJ board will seek New Jersey ARPA funds to enhance and sustain paid educational opportunities for individuals interested in entering or advancing their skills in the mobile healthcare or medical transportation field.
As you can see in the list above, we have our work cut out for us this year. However, I am confident that together we can continue to move our industry forward.
On behalf of my fellow MTANJ board members, I again thank you for your continued membership and participation. We look forward to serving you for many years to come.
Medical Transportation Association of New Jersey