Cash-Starved Ambulance Companies Seek $3 Billion in Virus Relief

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Like many executives in the health-care industry, Jamie Pafford-Gresham watched her company’s revenue plummet this year as fewer Americans went to hospitals, choosing to stay home and delay care amid coronavirus-related shutdowns.

Unlike many hospital executives, the CEO of Pafford Medical Services, which runs ambulances in several southern states including Arkansas and Louisiana, couldn’t furlough or lay off many of her staff to offset revenue losses. Her company had to keep its services active even when demand dropped by as much as 40% in late March.

“We have contracts that require us to have that safety net there,” Pafford-Gresham said. “So we went through a period of time where we didn’t get a lot of calls but we continued to have the same work force.”

Pafford-Gresham and other ambulance company executives watched as major hospitals got millions in emergency dollars to offset losses when many health facilities shut down in an effort to contain Covid-19. Now, ambulance providers are asking Congress for almost $3 billion in the next virus relief package.

Ambulance companies, as lawmakers continue to debate the details of the next relief legislation, also want the Health and Human Services Department to direct some of the $60 billion it has left in provider relief funds to their industry.

Chandan Khanna/AFP via Getty Images
Medics transfer a patient from an ambulance on July 30, 2020, outside Coral Gables Hospital where Miami-area coronavirus patients are treated.

The American Ambulance Association, the group that represents the industry in Washington, has been lobbying on the issue all year, according to federal disclosures. However, Congress left the decision about how to distribute relief funds to the HHS.

The group met recently with HHS officials and received no promises of earmarked funds, according to an AAA aide who asked for anonymity to discuss the issue.

The HHS has promised about $115 billion of the $175 billion in relief Congress approved this year to help health-care providers offset their Covid-19-related losses, according to agency data.

Aid Formulas

Safety net hospitals, nursing homes, dentists, hospitals with high numbers of Covid-19 patients, and rural health-care providers have all gotten targeted funds totaling roughly $60 billion.

Ambulance providers have gotten some relief. Pafford-Gresham said her company received enough to cover two weeks of operating expenses. The industry is making the argument it also needs a special fund. Expenses have grown this year as ambulance services and medics now need to be outfitted with protective equipment to ward off the virus.

The HHS distributed most of the relief using formulas that gave providers money based on previous Medicare billing or Medicaid data gathered by states. Ambulance companies have argued that because they represent just a small portion of Medicare’s overall spending, less than 1% according to an April letter to the White House from the AAA, the industry isn’t getting its fair share.

The ambulance industry is dominated by one company, Global Medical Response, which operates in most states and controls thousands of ambulances. Much of the industry is compromised of mid-sized regional companies like Pafford, hospitals, and local governments that operate their own services, Bureau of Labor Statistics data show. Global Medical Response is part of the AAA through its subsidiary American Medical Response.

So far, lawmakers haven’t taken up the ambulance providers’ cause. Neither the House Democrats’ nor the Senate Republicans’ proposals for the next virus relief package included special funding for the industry.

To contact the reporter on this story: Alex Ruoff in Washington at

To contact the editors responsible for this story: Robin Meszoly at; Sarah Babbage at

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