HELENA — Two years ago, a proposal to support Montana ambulance services through a new fee fell just short of becoming law. But the ambulance providers who backed that bill were hopeful they’d be able to get it through at the next state legislative session – and they were right.
In 2023, House Bill 828 passed the Legislature, but Gov. Greg Gianforte vetoed it, after lawmakers adjourned before approving changes he had asked them to make. Rep. Ed Buttrey, R-Great Falls, who sponsored HB 828, brought a similar bill this year, with House Bill 56. It passed with bipartisan support, and Gianforte signed it into law earlier this month.
“This is a lifeline for all of us EMS agencies that do transport,” said Don Whalen, manager of Missoula Emergency Services and president of the Montana Ambulance Association.
(Watch the video to see more about the impacts of HB 56.)
HB 56 sets up the framework for ambulance providers to pay a 5.75% fee on their own operating revenues. The state will take that money and use it as matching funds, to bring in more federal Medicaid dollars to support the providers.
Whalen said the extra funding will make a big deal for providers who are often running on very tight margins. He said EMS providers are trying to improve wages to recruit and retain employees, and they’re also dealing with significant cost increases for medical supplies.
“I think that's the same for all the little departments as well that do the same job that we do – we're stretched thin,” he said.
A spokesperson for the Montana Department of Public Health and Human Services told MTN about 75 ambulance providers across the state will be part of the assessment fee program. It will apply to services that are private or community nonprofits, but not those affiliated with local governments or tribes. Whalen said the affected providers run the gamut from large to small, urban to rural.
“Dillon, Montana, that's a private 501(c)(3) – Troy, Eureka,” he said. “I was shocked when we started looking at it. There are a lot of them out there in Montana.”
Whalen said most of the ambulance services that don’t qualify for this assessment fee are already participating in a similar program.
HB 56 becoming law is only a first step. The state will now have to put together rules for how the assessment fee will be administered, and they will need to get approval from the federal government before ambulance providers can start getting payments.
“That does take time,” said Whalen. “We would love to see it enacted next year – we really can't wait.”
An analysis done during the legislative session by the governor’s budget office estimated the assessment fee would bring in $6 million a year from providers – but that it could secure another $30 million a year in federal matching funds. However, those numbers could still be subject to change, especially if there are any major changes to Medicaid on the federal level.
