MMA letter urging the governor to sign ambulance payment legislation

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His Excellency Deval Patrick
Governor of the Commonwealth
State House, Boston

Dear Governor Patrick:

On behalf of the cities and towns of the Commonwealth, the Massachusetts Municipal Association is writing regarding H. 3917, legislation relative to payment for use of ambulance services. This important measure, which has been enacted by the Legislature, would protect emergency medical services (EMS) from threats of payment disruption and under-funding and would establish a strictly capped system for setting rates. Municipal officials and emergency response professionals, including the Fire Chiefs Association of Massachusetts, support this bill and respectfully ask you to sign it into law.

Passage of this legislation this session would restore much-needed stability to municipal finances and to emergency medical services programs across the state. Threats of “pay the patient” and under-funded reimbursements undermine the ability of cities and towns to fund and operate responsive and efficient ambulance services that are the backbone of emergency medical response in Massachusetts.

H. 3917 would prohibit the “pay the patient” practice for emergency medical services through which insurance companies would make payment to the person who used the emergency medical services and require the city or town to attempt to collect the fee from the person. Currently, insurance companies reimburse local ambulance service providers, mainly cities and towns, for the cost of emergency services. “Pay the patient” is incredibly inefficient and subject to abuse and misuse.

The legislation would also set the rate for EMS at a rate equal to the lower of either the ambulance services provider’s usual and customary charge for the ambulance service rendered to the insured or three times the then-current published rate for the ambulance service rendered to the insured as established by the Centers for Medicare and Medicaid Services. This tight cap provides a solid and reasonable compromise between insurance companies and municipalities and avoids shifting costs to local property taxpayers through below-cost reimbursements.

We believe this legislation would protect municipal EMS services and allow for a balanced approach to rate-setting for emergency ambulance services, and we urge you to sign the measure into law. If you have any questions regarding this important issue, please do not hesitate to have your staff contact MMA Legislative Director John Robertson at any time. Thank you very much for your consideration and support for cities and towns.


Geoffrey C. Beckwith
Executive Director, MMA