April 3, 2020
The Honorable Tony Evers
Governor of Wisconsin
115 E Capitol Dr # 1
Madison, WI 53702
Dear Governor Evers,
The projected peak of COVID19 is hitting affecting EMS in Wisconsin at a difficult time. EMS providers across our
state are preparing for a severe spike in services in the next several weeks. Under the State’s Medicaid program,
ambulance services have not received a rate adjustment since 2008, when a symbolic 1% increase was
effectively offset by other programmatic changes.
Flat reimbursement rates over the last 12 years have left us operating with extremely difficult financial
conditions and limited the ability of our services to compete for staff. We have been working on
recruitment and retention issues for many years.
The recent federal stimulus packages allow a temporary rate increase for ambulance services without the need
for any additional GPR. Specifically, the packages increase the federal matching rates (FMAP) by 6.2%, meaning
Wisconsin will receive more federal funding for the same level of GPR that is approved in the 2019-21 State
budget.
Even with such an increase, Wisconsin’s Medicaid program lags far behind the federal government and
neighboring states in reimbursements for EMS. Wisconsin currently reimburses EMS services providers at a
rate of 42% of the federal Medicare rate, an already below-cost reimbursement rate as established by the
Congressional Budget Office. With an increased rate made possible by the new federal stimulus packages,
Wisconsin’s Medicaid reimbursement rate should be increased to the federal Medicare rate.
In addition, COVID19 is adding over $20 to the cost of every ambulance response. Daily employee health
screenings, new decontamination protocols after COVID19 encounters and added equipment and supply
costs are increasing the loss experienced on each Medicaid transport. All of our 800 EMS services
providers are already finding it very difficult to continue operations through this crisis.

The Governor’s legislation yesterday included an increase for several other providers but not EMS. In
addition, the legislature gave an increase in current state budget to some providers, but EMS was
left out of that as well. EMS should not be left out again!
We are asking you to authorize increasing the Wisconsin Medicaid reimbursement rate for EMS to the
current Medicare rate for each service level. Thank you for your consideration.
Marc Cohen
WEMSA

Chris Anderson
PAAW

Tim Bantes
WSFCA

Mahlon Mitchell
PFFW