Ambulances among biggest in Medicare payments

Posted: April 11, 2014

It doesn't take many customers to build an ambulance business, according to Medicare payment data released Wednesday by federal regulators.

For example, Red Cross Ambulance, which is based in Huntingdon Valley and operates two ambulances, state data show, collected $395,601 from Medicare for a dozen patients in 2012.

That amounted to an annual average of nearly $33,000 per patient. It's not clear how many trips Red Cross made or whether it provided service to those patients for the full year.

The company has no affiliation with the humanitarian relief organization, the American Red Cross.

No one answered the phone at Red Cross' offices, which are in World Executive Suites, an office building on Philmont Avenue.

By contrast, the two biggest for-profit ambulance companies in the region - Exceptional Medical Transportation in West Berlin and Keystone Quality Transport in Springfield, Delaware County - transported thousands and collected a full-year average of $500 to $600 for each patient.

The data released Wednesday by the federal Centers for Medicare and Medicaid Services detailed payments to doctors and other service providers. It was part of an effort by federal officials to foster greater financial transparency in health care.

In the eight-county Philadelphia region, ambulance companies ranked third in Medicare payments, with a total of $118 million. In terms of provider types, only internal medicine doctors, with $142 million in payments, and ophthalmologists, with $138 million, ranked higher.

Ambulance payments are a hot-button issue in the Philadelphia area, where regulators in January issued a moratorium on new Medicare provider numbers following a series of fraud convictions and an analysis showing that Medicare billing for ambulance services here is higher than in other regions.

There are 86 for-profit ambulance companies in Southeastern Pennsylvania that operate just one or two vehicles, according to the Pennsylvania Bureau of Emergency Medical Services.

Some small ambulance companies are taking advantage of Medicare's willingness to pay for trips to dialysis centers, though it's only supposed to pay for an ambulance for patients who absolutely need it, said Joseph Zupnik, an owner of EMStar, a Philadelphia medical transportation firm that recently merged operations with Keystone Quality Transport.

Zupnik said Medicare easily pays $1,500 a week in transportation for a dialysis patients. "If you sign up 10 or 12 or 20 patients like that and you're making a good living, you're not making an honest living. You're making a good living," he said.

At Victory Ambulance, in Huntingdon Valley, a man who answered the phone and identified himself as the manager said the company works with hospitals and nursing homes.

Asked to confirm that in 2012, 14 Medicare beneficiaries resulted in $355,969 in revenue, for an average of $25,284, the man said he didn't know: "I wasn't here at that time. I'm a new manager in 2013."


hbrubaker@phillynews.com

215-854-4651

@InqBrubaker

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