U.S. Sen. Roger Marshall takes flight for appeal on improving air ambulance reimbursement

EMPORIA — U.S. Sen. Roger Marshall squeezed into the back seat of the helicopter, adjusted a headset so he could communicate with the pilot and nurse, and lifted off on a 10-minute flight to quickly expose him to sounds and sights of an emergency medical flight.

Marshall, a Republican senator by election and a physician by profession, was no novice to the value of air transportation when caring for people in life-or-death circumstances.

“I practiced medicine in Great Bend for 25 years. I delivered a baby every day and would use helicopter services once a month. Every minute counts,” Marshall said. “Obviously, if you’re in Wichita and you need transportation, it’s going to be quicker to go by ground. If you’re in Atwood, Kansas, you need the helicopter. That’s just life in rural America.”

Marshall was on the Newman Regional Health helipad Friday to learn more about financial obstacles faced by air medical carriers.

He was a guest of LifeSave Kansas, a subsidiary of the Air Methods company that operates from more than 300 bases in 48 states. LifeSave has the helicopter based in Emporia and fixed-wing aircraft stationed in Liberal and Wichita. The company’s goal has been to sustain a network of aviation resources to transport patients at more than 100 mph from place to place, especially Kansans who live the greatest distance from major hospitals.

Carolyn Mayle, a vice president at Air Methods, said 40% of the company’s flights involved Medicare patients and 25% of flights were for Medicaid patients. She said state and federal government programs didn’t pay the full cost of emergency flight services.

Congress has an opportunity to work toward a more equitable compensation system for air carriers, she said.

“Medicare is used as a benchmark,” Mayle said. “Which is fine if Medicare pays their costs. For most providers, they pay 80% to 90% of costs. For air ambulance, it’s about 50%. Our reimbursement has not been updated by the government in over 20 years.”

She touted a bill cosponsored by U.S. Rep. Ron Estes, R-Kansas, that would update Medicare reimbursement rates for emergency air services by requiring compensation to be linked to data on actual costs. The bill has been reintroduced in the House and Senate.

“The bipartisan bill … is a common sense way to ensure all Americans have emergency access to hospitals and specialized providers regardless of their location,” Estes said in a statement. “When seconds matter, air ambulances have proven to be the best way to care for patients in need, and under this legislation, the work of the pilots and medical professionals on board will continue to save lives.”

Brittany Cox, area manager of the LifeSave, said the legislation would be an important step in solidifying emergency air transport operations.

“Being part of the emergency medical system gives me an up-close look at the challenges facing rural Americans when it comes to accessing critical trauma care,” said Cox, a nurse who had worked in western Kansas. “Timely access to emergency care can mean the difference between life and death.”

Marshall made no commitment on the pending legislation but said he was interested in creating savings in the Medicare Advantage program by deterring the practice of service providers reporting diagnosis codes to made patients appear sicker than they were.

He estimated the epidemic of upcoding Medicare patients cost the federal government a couple of hundred billion dollars each year.

“I would like to take some of that savings and then figure out an increase reimbursement for Medicare for this type of thing. There’s plenty of money being spent in Medicare, but it’s not always being spent the most efficient way,” the senator said.