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State Cuts Hit Ambulance Services

CHATTANOOGA, Tenn. -- Ambulance services are feeling the pinch of $4 million in state cuts to Medicare Part B providers, emergency officials around the region say.

Although cuts were aimed at a portion of nonemergency transportation payments, the impact will be felt in other areas too, said Danny Lawson, director of Bradley County's Emergency Medical Service.

"I don't think they realize the effect it has on local communities," Mr. Lawson said about the 20 percent funding cut, announced after local governments already had finalized their annual budgets.

Bradley County ambulances are staffed with highly trained paramedics and costs are the same whether they're hauling a car wreck victim to the emergency room or an elderly patient to a doctor's office, he said.

Using 2007's EMS budget for example, "the 20 percent loss that we would have experienced last year was $205,361," he said, and he projected the loss to the service this year at more than $219,000.

Mr. Lawson said the state will gain $4 million, and local governments will have to make up at least $11 million in lost state and federal payments.

Medicare pays 80 percent of the cost to transport TennCare patients who qualify for Medicare. Medicaid, which funds the TennCare program, paid the remaining 20 percent.

Tennessee started out the fiscal year with a $500 million deficit and went another $50 million in the hole the first month, according to a letter from Finance Commissioner Dave Goetz in response to requests to restore the funds.

"We thought that reducing supplemental payments to providers who are already receiving payments that amount to 80 percent of the Medicare fee schedule was the most reasonable approach to take," Mr. Goetz wrote, adding the state can't afford the "substantial additional payments from TennCare."

Sen. Thelma Harper, D-Nashville, chairwoman of the Senate Government Operations Committee, said state officials "meted out a disservice" by making the cuts after local governments had set their budgets.

"It looks like many of the small ambulance services will not be able to carry out their mandate," she said.

Chief Ken Wilkerson, of Hamilton County EMS and Tennessee Ambulance Service Association vice president, said, "In some counties across the state, this will directly relate to the level of services they are able to provide."

It could mean fewer personnel and vehicles and slower response times, he said, and private services will feel it worst.

Tim Evans, a paramedic and director of privatelyowned Med Trans in McMinn and Polk counties, said his company's losses could "easily go into a six-figure-per-year" loss. "It's just another thing making it difficult to survive in this line of work."

Finance Commission spokeswoman Lola Potter said relief depends on the economy.

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