The Washington County Ambulance Service is down $30,000.

At Tuesday’s Washington County Board of Supervisors meeting ambulance staff Jamie Brame and Dixie Young said under House File 653 that was signed by Governor Terry Branstad the Managed Care Organizations (MCOs) don’t have to reimburse services at the previous rate. Brame explained the change that took effect this summer and how the MCOs reimburse providers, “How it used to work is if a patient was covered under Medicare but couldn’t afford a secondary supplementary they would have a Medicaid. And whatever deductibles, co-insurance, whatever you have after Medicare pays these MCOs or Medicaid then cover, so it’s about 20% of the bill. They have now decided in this new legislature that they are not going to cover this 20% anymore, it has to be written off.”

The MCOs have contracts with the state of Iowa to manage Medicaid. Approximately 30% of the patients the ambulance serves are under Medicaid. Supervisor Jack Seward said it impacts many providers, “So my understanding is the bottom line is the MCOs are fully funded but the providers are not.” Those providers include ambulance, hospitals, nursing homes, mental health and disability services, minibus, and other providers who work with Medicaid patients.

Supervisor Chairman Richard Young, who is also the ambulance director, explained ambulance services are not considered an essential service per state code, and he has been working since 1985 to change this. He said currently there is a united push across the state for the change and recommended people reach out to state legislators.