Isle lawmakers
issue appeal to feds
to save air ambulance

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By Helen Altonn
haltonn@starbulletin.com

Hawaii's 76 legislators have appealed to U.S. Health and Human Services Secretary Tommy Thompson to try to save the only air ambulance serving neighbor islands.

In a letter to Thompson, the legislators reaffirmed a resolution they passed last year asking that Medicare fees be readjusted because they're far below Hawaii Air Ambulance's operating costs. As a result, they said the ambulance service "is experiencing significant financial hardship."

The company, nearly 22 years old, makes about 150 to 180 flights per month to bring patients from neighbor islands to Oahu, said president Sandy Apter. It provides bed-to-bed transportation for critical patients and arranges some private charter medical flights from here to the mainland. It has a flight-ready crew on Oahu around the clock, and on-call staff at Big Island and Maui stations, she said.

Apter said many of the 90 employees have been with the company since it began.

The company has struggled to avoid bankruptcy. With Medicare reimbursements so low, Apter said, "We have to watch every penny."

The legislators noted to Thompson that Medicare's allowable rate from Molokai to Honolulu is $937.62, compared with a proposed rate of $4,071.90 by the Centers for Medicare and Medicaid Services (CMS).

The current Medicare rate for a flight from Lihue, Kauai, to Honolulu is $1,282.89, while the Centers for Medicare and Medicaid Services has proposed $4,516.15, the letter said.

"Furthermore, Hawaii's Medicare reimbursement rates for air ambulance services have not been adjusted for 15 years," it said.

Sen. J. Kalani English (D, Wailuku), majority floor leader, said this is "a major health issue. Given the unique geographical set-up of our islands, this is an essential medical service for the health of those on the neighbor islands."

Leading a bipartisan effort to try to maintain air ambulance services from the neighbor islands to Oahu, English introduced a resolution in the last session urging Congress and the Health Care Financing Administration to adjust Hawaii's aeromedical rates.

"It is unfair for Hawaii to receive one of the lowest air ambulance reimbursement rates in the country and expect medical air transport companies to survive," he said.

The letter to Thompson said Hawaii Air Ambulance provides the only emergency medical transportation from the neighbor islands to Oahu medical facilities, yet Medicare reim- bursements are below costs for more than half of its missions.

"The demise of HAA would leave Hawaii without an inter-island aeromedical provider that now services millions of Hawaii residents and visitors in the state of Hawaii," the letter said.

The 1997 Balanced Budget Act required the Centers for Medicare and Medicaid Services to implement a new Medicare schedule by Jan. 1 this year to provide relief to national air ambulance providers, the legislators pointed out.