GREAT FALLS — The Department of Veterans Affairs is responsible for veteran's benefits across the country.
A new VA rule, which has since been delayed, poses threats to rural ambulance and air transportation services.
"We were fairly concerned when the VA posed to cut ground ambulance reimbursement to Medicare allowable rates," explained Great Falls Emergency Services General Manager Justin Grohs.
According to Grohs, Medicare and Medicaid reimbursements for ambulance services in Montana payout at 30-40% below operating costs.
As a private entity, contracted with the City of Great Falls, GFES and Life Flight Network are working with Montana's Congressional delegation to create a better plan.
"This is a problem we find all the time back here. That people who don’t come from rural America don’t understand the challenges. That doesn’t make them bad people. What it means is we must educate them and let them know, and we’re educating the VA right now on air and ground ambulance service," said U.S. Senator Jon Tester (D-MT) and Chairman of the Senate Committee of Veterans Affairs.
"What we’re telling the VA is that you put out this rule, now you gotta sit down and negotiate. You gotta negotiate with folks like Great Falls Emergency Services," Sen. Tester continued. "To make sure that they’re not breaking the bank and you’re not eliminating them from doing business in North Central Montana."
With the cost of inflation and the processes behind Medicare and Medicaid, ground ambulance services aren't the only ones affected.
Life Flight Network is based out of Oregon, but contracts through Washington, Idaho, Montana, and its home state.
Ben Clayton is the CEO of the air ambulance service, spending much time in Washington D.C. negotiating for rural ambulance providers.
"Fortunately, the VA decided to voluntarily delay, which is great. We would still love to work with them. It’s just we’ve had a really difficult time getting any traction and working collaboratively with the VA." He said.
Inflation and operating costs have hit rural communities the most.
In July 2023, Eagle Ambulance in Granite County closed operations. It was undisclosed the motive behind the closure, but after MTN spoke with Montana ambulance administrators, operating and reimbursement costs is an issue across the state.
Life Flight Network considers the needs in the communities it operates in and has considered holding projects for higher demand.
"We look at where is the need in the community, and there are projects that are put on hold that where I know that people need a service like ours that I’ve been willing to commit to because there are so many uncertainties," Clayton explained.
Great Falls Emergency Services and Life Flight Network have worked closely with Congressman Ryan Zinke and Senator Tester's office, to create a push for fair reimbursements for rural providers.
It's an effort they say has bipartisan support in Congress, but lacks that same consideration in the VA Office.
"We would suggest a study. How these services would affect the VA and what the options are where there may be areas for cost savings, we’re certainly open to those conversations," added Grohs.
There is currently a study through the federal government that is evaluating the exact cost of operating an ambulance service.
While that study is in the process, Grohs and Clayton encourage the VA to assess that value and take it into account — and adjust accordingly to the needs of the providers and veterans.
In the Montana State Legislature, HB 828 made it to Governor Greg Gianforte's desk and was vetoed under certain clauses in the legislation.
The bill was sent back to the debate and was never enacted into law. Grohs told MTN News that some of the provisions in HB 828 would benefit ambulance providers in rural Montana and he hopes in the next legislative session, these needs can be resolved.
"We have challenges out that can address these rules and oftentimes, a one size doesn’t fit all and that’s we’re telling them they need to sit down and negotiate and talk to folks like Great Falls Emergency Services... If they’re able to do that and work with those stakeholders, they can come up with a rule that meets the needs of not only the stakeholders but the veterans they serve." Tester added.
The rule is anticipated to be delayed until February 2025 while further negotiations continue in Washington.
