Some ambulance bills in the region will go up after the Public Regulation Commission on Thursday approved a rate hike for Albuquerque Ambulance Service.
The increase will push the rates of the Presbyterian-affiliated nonprofit ambulance company to nearly double that of average ambulance rates in the state, with a 65% increase in service rates and a 15% increase in mileage rates.
The increase comes as a result of negotiations between the organization and commission staff after Albuquerque Ambulance Service requested a 100% increase in service rates and a 25% increase in mileage rates in January. This was a decrease from its initial proposal for a 175% increase last year.
Albuquerque Ambulance Service provides emergency transportation in Bernalillo, Sandoval, Santa Fe and Rio Arriba counties and performs 90,000 to 100,000 transports per year, according to its filings with the commission.
The nonprofit ambulance company cited rising costs of labor and inflation in its application for the rate increase, which is its first since 2013. Presbyterian Healthcare Services has covered more than $12 million in operating losses for the ambulance company since 2019, according to the company’s filings with the commission.
Commissioners unanimously approved the increase to the company’s rates and mileage fees Thursday morning without discussing the case or posing questions to the state’s regulatory staff.
The change will increase the rate for the first mile of service for emergency transport of a patient with “basic life support” care from $566.40 to $934.56; the statewide average rate for the first mile of such service is $512. The flat rate for each mile after the first mile, regardless of what type of service is provided, will increase from $11 to $12.65, just under the statewide average of $12.75.
Commission staff pointed out in a stipulation agreement the rate increase will not apply to patients covered by Medicaid, Medicare, Tricare or veterans benefit services, which are charged a separate set of rates. The first mile of service for emergency transport of a patient with “basic life support” is $484.36 for Medicaid patients and $415.99 for Medicare patients.
Patients who are covered by either Medicaid or Medicare make up about 77% of the organization’s transports, commission staff wrote in a brief.
“The amount paid by a patient for an ambulance bill depends on the coverage provided by their insurer,” Albuquerque Ambulance Service Chief Julia Heinz said in a statement through a Presbyterian spokeswoman, adding, “We do not anticipate significant changes for patients as a result of this approval.”
State regulatory staff wrote in the brief that those without health insurance would be most affected by the rate hike.
“The group that would be most impacted by the increase to [Albuquerque Ambulance Service’s] tariff rates would be those who self-pay and are without any insurance coverage,” it states, adding the group makes up about 7% of the company’s transport patients.
Although commission staff initially recommended a rate increase of only 35%, a hearing examiner in the case wrote in a filing the recommendation “was no longer applicable due to a misunderstanding at the time of the recommendation regarding AAS’s revenue modeling concerning the categories of Charity Care and Bad Debt.” The initial recommendation would have left the company’s operating costs higher than its annual revenue, he wrote.
Commission staff determined the 65% increase to rates was fair and reasonable and “justified to maintain ambulance service at a level designed to curtail the recurrent operating losses” for the company.
