BCBS reimbursement policy costs ambulance firm $3M

Blue Cross Blue Shield of Massachusetts' practice of reimbursing patients directly for ambulance services has caused the American Medical Response (AMR) to lose millions of dollars and lay off employees. The policy, which Blue Cross implemented in 2010, means the insurer hasn't paid AMR $3 million for ambulance transportation, reported the Boston Herald. Although Blue Cross typically pays its in-network ambulance companies directly, AMR has refused to sign a contract with the state's largest insurer because it "doesn't pay for the cost of service we provide," said Brendan McNiff, general manager for AMR, the nation's largest private ambulance service.

However, Blue Cross said its decision to pay patients instead of AMR is about affordability. "In recent years, out-of-network ambulance companies have charged our customers prices that are 300 (percent) to 500 percent more than what Medicare pays for the same exact service," Blue Cross spokeswoman Sharon Torgerson said. "In an effort to rein in these runaway costs, we took aggressive action two years ago that introduced an initiative to pay our customers directly for ambulance services for ambulance companies that refused to contract with us." Article