STATE HOUSE — When Chief Andrew Kettle receives a dispatch call, he sends an ambulance of trained professionals to provide rapid, quality care. But if the patient in question gets their health insurance through Medicaid, the nonprofit he operates will lose hundreds of dollars on that service.

Sen. Victoria Gu (D-Dist. 38, Charlestown, Westerly, South Kingstown) and Rep. Tina Spears (D-Dist. 36, Charlestown, Westerly, South Kingstown, New Shoreham) are hoping to change that. Legislation they are sponsoring would increase the Medicaid rate of reimbursement for ambulance services.

“Our emergency services are an absolutely vital community resource,” said Senator Gu. “We need to make sure we’re providing them the resources to recruit and retain qualified first responders. And we should be making sure those first responders are paid a decent wage. Otherwise, response times and quality of care may suffer.”

Almost a quarter of the state’s population is covered by Medicaid, which pays for health care needs, including ambulance services. Chief Kettle runs Charlestown Rescue, a private nonprofit that provides all emergency rescue services for the town of Charlestown. He estimates his agency loses about $260 on every emergency call from a Medicaid patient. Those funds must be made up for by support from the town of Charlestown, which puts the burden on property taxpayers. Even then, Chief Kettle says, he is struggling to stay afloat.

“If you call 911, we will send an ambulance with half a million dollars’ worth of equipment and trained professional first-responders including Emergency Medical Technicians, cardiac specialists and paramedics,” said Chief Kettle. “But if you have Medicaid, we get paid about $75 for that ride. We will absolutely respond to your emergency, but we are stuck figuring out how to pay for it all after.”

In Rhode Island, Medicaid pays a flat rate of $69.95 per ambulance ride with an additional $0.56 per

mile. That is less per mile than the IRS reimbursement rate of $0.655 per mile. In Massachusetts, Medicaid pays flat rates ranging from $250.65 to $334.19 and Connecticut Medicaid pays $220.44 to $293.90, based on the acuity of the patient. Massachusetts pays an additional $6.45 per mile and Connecticut pays an additional $5.88, according to information provided by Chief Kettle.

The legislation (2023-S 0516, 2023-H 6119) would increase the Medicaid rate of reimbursement for ambulance and wheelchair van services to not less than ninety percent (90%) of Medicare rates for the same medical services. Medicare, paid for by the federal government, pays a base rate of $265.54, with significantly higher rates based on the acuity of the patient. Medicare also reimburses at least an additional $8.54 per mile. Data can be found on the Center for Medicare and Medicaid Services website.

“Our emergency responders are trained professionals who work 24/7/365, with the lives of our neighbors in their hands. We’re asking them to do a stressful job, away from their families on weekends and holidays, and some get paid as little as $18 per hour,” Chief Kettle said. “We really need to pay them better. This bill will help us do that, and I’m so grateful to Senator Gu and Representative Spears for their efforts.”

The town of Charlestown subsidizes Charlestown Rescue directly from the town budget to help keep the agency fiscally solvent. In many other communities, municipal employees are responsible for providing ambulance services. The insufficient Medicaid rate puts a strain on municipal budgets and, ultimately, property taxpayers.

“Health insurance coverage needs to pay fairly for services and our hard-working emergency professionals,” said Representative Spears. “Rhode Island Medicaid rates for critical life-saving transports shouldn’t be the worst in the nation, and right now we are.  I believe fair compensation for essential services when our community members are in a medical crisis should be a top priority for insurers in Rhode Island. This bill will ensure our local towns are able to quickly respond to the medical crises in their communities.”

Both bills will have their first hearing on Thursday, May 4. The House Committee on Finance will hear Representative Spears’ bill at the rise of the House (sometime after 4:30 p.m.) in Room 35 in the basement of the State House. The Senate Committee on Finance will hear Senator Gu’s bill at the rise of the Senate (sometime after 4:30 p.m.) in Room 211 on the second floor of the State House.