Indiana EMS agencies drowning in debt due to unpaid patient bills

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INDIANAPOLIS, Ind. — Some EMS agencies in Indiana say they are drowning in debt due to unpaid patient bills, and paramedics worry somebody will call 911, but no one will be there to help.

“I expect by the end of the year, it will be well over a million dollars,” said Nathaniel Metz, president of the Indiana EMS Association.

Metz said that debt is just for his agency in Lafayette called Phoenix Paramedic Solutions. He said it is a problem statewide that comes from low Medicare and Medicaid reimbursement rates and little to no coverage from insurance companies, which leaves many patients unable to cover the full cost.

“Agencies are not going to be able to afford to put paramedics on their ambulances anymore, and that is going to directly impact the patients,” said Metz.

Metz said hospitals, especially in rural communities, are seeing a decline in access to ambulances.

“They have to wait six, seven, eight, nine hours sometimes for a transport to get a critical patient, even child at times, transported to an appropriate facility so they can have the right level of care,” he said.

Trans-Care Ambulance in Indianapolis said it will also write off more than $1 million this year for bad debt. The agency said Medicare and Medicaid reimburse at levels below the cost of providing the service.

Even though demand is going up, paramedics said low salaries make it hard to encourage providers to stay.

“Typically in EMS, EMTs and paramedics have two or three jobs. We have people here by choice, not by force, working 60 hours a week, every week,” said John Thrasher, a paramedic with Trans-Care Ambulance.

Metz said the industry is at a breaking point, and the burden could be placed on tax payers if nothing changes.

“They have to decide what to do with their limited tax dollars. Is it fix roads? Is it invest in our schools or help subsidize EMS departments?” he said.

Indiana EMS Association is calling on lawmakers to act. Something they want to see is a change to Medicaid reimbursement rates.

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