According to the complaint, AMED filed a lawsuit against the Department of Veterans Affairs in federal court seeking to block a VA rule that drastically reduces payments for transporting veterans to community hospitals from list prices to the amount provided by Medicare. It is one of four service companies.
AMED Executive Director Gary Watters said if the Veterans Administration were to adopt this rule, it would cost AMED about $500,000 a year and provide veterans with lower Medicare payments and list price transportation. He said that he would technically be responsible for paying the difference.
The Department of Veterans Affairs originally planned for the rule to go into effect in February, but the agency notified the Federal Circuit last week that it intended to delay the effective date until February 2025, prompting the court to It was announced that the case could be given time to consider. and rule on the ambulance service’s argument that the VA plan violates the law.
According to the ambulance service, the law requires the Veterans Administration to pay “the customary and usual cost of emergency treatment, or payment of reasonable consideration for emergency treatment,” unless the patient is “transported to or from a VA facility.” is required. In this case, the law authorizes the Veterans Administration to pay only the Medicare amount.
The VA wants the provision to apply to patients entering and exiting VA facilities and also cover transfers to local hospitals, according to the complaint.
Ambulance services claim the proposal goes “far beyond plain text” and “swallows the rest of[the relevant provisions]”.
There is no dispute that the payments are covered under the contract between the Veterans Administration and the ambulance service.
The Veterans Administration has not yet released its position on the legal merits of the case in a court filing.
“While we do not agree with the allegations advanced by the[ambulance service]we hope that future action by the Department of Veterans Affairs will provide the relief that the claimants seek, so at this time we are fully addressing the claims. “We believe there is no need to respond,” the Veterans Administration said.
The proposed one-year delay is good news, according to the Pennsylvania Ambulance Association, which filed a court brief supporting the ambulance service.
Still, the petitioners, MedStar Mobile Healthcare of Texas, Valley Ambulance of Coraopolis, Quaker Valley Ambulance of Moon Township, and AMED, are concerned that the Veterans Administration has yet to formally announce the proposed deferral. The company asked the court to grant the suspension as originally requested.
Failure to do so risks “irreparable harm,” the appellants said.
The revised payments would be “less than the cost of providing transportation,” as opposed to “100 percent of the actual charges” that the VA currently pays to ambulance services, according to the lawsuit.
As a result, the ambulance service will be forced to “reduce operations through layoffs and, in some cases, furloughs and reduced hours for remaining employees,” the complaint says.
A typical Advanced Life Support trip through AMED costs $2,100, Watters said.
Depending on the level of service provided to individual transportation agencies, Medicare payments to AMED can be up to $258, he said.
“The whole point is they’re shifting the burden onto the veterans,” Watters said of the VA.
Mirror Staff Writer William Kibler can be reached at 814-949-7038.