After holding three monthly meetings that delved into the state regulations governing the ambulance and medical transportation industry, a study committee is preparing to make recommendations for legislative changes.
Republican Rep. Michelle Ugenti of Scottsdale, chair of the committee, said the process by which ambulances and medical transportation providers are licensed amounts to creating monopolies. She identified several areas of reform that could add competition without disrupting service.
“I have a couple of ideas for where some reforms lie… I’m looking at revisiting the (licensing) timelines, and potentially shortening some. Perhaps adding some consequences for not meeting certain timeframes so everyone knows what to expect (from the government agencies in charge of licensing),” Ugenti said.
Medical transportation businesses are licensed to operate with “certificates of necessity,” which are issued by the Department of Health Services. The certificates allow ambulance companies, municipalities or fire districts that own them a virtual monopoly to operate within certain geographic boundaries. When considering issuing a new certificate, DHS takes into consideration the financial impact it will have on existing certificate holders.
But the certificates come at a price — and ambulance businesses must provide service to everybody within their service area, regardless of the customers’ ability to pay.
Ugenti didn’t advocate for doing away with certificates of necessity altogether. She said there are several changes she hopes to make next year to the way they are issued.
She also advocated making changes to the way ambulance rate increases are approved, and ending the practice of automatically approving some rate increases.
The committee heard from Bud Payne, chief of Pinal Rural Fire Rescue, a nonprofit volunteer fire department in rural southeastern Pinal County, who said one of his area’s ambulance providers is often unreliable, leading his department to seek its own certificate of necessity to operate ambulances.
But navigating the web of government regulations proved too burdensome, and eventually, the department dropped the fight, only to take it up again recently.
He worries the department cannot afford the same legal representation that the current ambulance operator can afford, and won’t be able to win a certificate to provide ambulance services in the area.
“I honestly do not think this is going to go through to the benefit of the people,” Payne said, urging the committee to make obtaining certificates a more competitive process.
The House Ambulance Medical Service Transportation Study Committee is scheduled to hold its last meeting in December, where members of the committee will make their final recommendations for changes to the laws and regulations surrounding the industry.
Ugenti said she will sponsor legislation to enact the changes recommended by the committee.