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Ambulance services receive federal aid after nearing 'breaking point'

The Department of Health and Human Services announced they would receive $1.48 billion.
Image: First Responders In Maryland Work As Coronavirus Cases Rise Across The Nation
Firefighters and paramedics with Anne Arundel County Fire Department load a patient into an ambulance while responding to a 911 emergency call in Glen Burnie, Maryland, last Friday.Alex Edelman / Getty Images file

Private ambulance companies will receive a sizable sum of federal aid after facing a fiscal cliff since the beginning of the pandemic, putting the nation's ability to respond to 911 calls at risk.

The Department of Health and Human Services announced on Wednesday that it would provide $24.5 billion from the Provider Relief Fund to more than 70,000 health care providers nationwide, including EMS services.

“With the Provider Relief Fund, we’ve been able to support providers hardest hit by COVID-19, including safety net hospitals, rural providers, and nursing homes, helping ensure they can continue serving their communities during and beyond the pandemic,” HHS Secretary Alex Azar said in a statement.

The sum includes $1.48 billion for ambulance services that are increasingly cash-strapped — receiving limited relief from the federal government thus far — as the nation faces another surge in coronavirus cases.

The HHS funding comes mere weeks after NBC News first reported that the American Ambulance Association sent a letter to HHS warning “the 911 emergency medical system throughout the United States is at a breaking point. Without additional relief, it seems likely to break, even as we enter the third surge of the virus in the Mid-West and the West.”

The $1.48 billion is on top of the $350 million ambulance services had received from the federal government since the beginning of the pandemic for a total of $1.83 billion.

"This pandemic has been devastating and impacted all involved in our healthcare ecosystem," an agency spokesperson said. "HHS is distributing relief funding in a way that is fast, fair and transparent."

The final amount still falls short of what its members needed to keep up with operating costs, the group said, but they were thankful for the help. The ambulance association had fought for $2.62 billion in support of its members for months. That number would have amounted to about $43,500 for each of the approximately 60,000 ambulances that answer 911 calls.

“The American Ambulance Association would like to thank HHS for the additional significant funding which will be vital to maintaining a strong EMS infrastructure both during the public health emergency and beyond," the association said in a letter to its membership. "We would like to also thank all of our members who reached out to the Administration and Congress advocating for additional relief."

Ambulance companies no longer get as many valuable 911 or hospital transfer calls that they once received, as hospitals, nursing homes and people put off surgeries and other medical procedures because of the pandemic. EMS services have also been forced to buy more personal protective equipment to stay safe, and prices have shot up 20 to 25 percent in recent months.

Revenue, meanwhile, has collapsed even further because ambulance services are now expected to treat people in place at the scene of an emergency. This has become the new standard of care during the pandemic to limit hospitalizations, but the Centers for Medicare and Medicaid Services does not reimburse companies for this method of treatment, and most insurance providers follow its lead.

An HHS spokesperson previously told NBC News that the agency had opened a third round of funding of $20 billion last month, which they said was available to ambulance services.

That third phase of funding, however, came with a limit, ambulance companies said, and only recouped their losses and expenses up to 2 percent of their 2019 revenue.

Ambulance services were pessimistic that they would receive the funding they needed to maintain through the winter, a period Robert Redfield, director of the Centers for Disease Control and Prevention, said would be the "most difficult time in the public health history of this nation."

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After the agency received applications, HHS said it would need more funds and added $4.5 billion in an attempt to "satisfy close to 90 percent of each applicant’s reported lost revenues and net change in expenses caused by the coronavirus pandemic in the first half of 2020."

"Recognizing the ongoing challenges this pandemic continues to precipitate for providers, including ambulance providers, in Phase 3, HHS enhanced the distribution opportunity to consider the actual revenue losses and expenses experienced by providers that were attributable to COVID-19," an HHS spokesperson said. "HHS is pleased ambulance providers took advantage of this opportunity and will be receiving funding to help mitigate some of the challenging financial impacts this pandemic has caused."

HHS and the the Provider Relief Fund was one of the few avenues left to private ambulance companies, which respond to about a third of the country's 911 calls. Congress is finalizing talks for the next Covid-19 relief bill, and EMS services are unlikely to receive funding in that package.

“I just don’t think Congress is itching to put in any kind of language that would carve out anything specific to industries," a Republican Senate staffer previously told NBC News.