Medicare doesn’t pay enough to cover the cost of many ambulance transports, so Congress has been passing legislation each year to help fill the gap. The uncertainty year after year complicates budgeting for local fire departments that provide the service, especially in smaller rural areas like Eastern Oregon.

U.S. Rep. Greg Walden, R-Hood River, is trying to address the problem with a bill to make the short-term relief permanent.

It’s a good move. Smart planning isn’t possible when one major component of a department’s budget is uncertain. And small fire departments aren’t in a position to absorb the difference between actual costs and Medicare’s limited reimbursements.

According to the Government Accountability Office, the median cost of ambulance transport in 2012 was $429, ranging from $224 to $2,204. Average reimbursements in super rural areas, however, were 14.3 percent lower than those costs. Closer to home, Redmond Fire & Rescue reports 45 percent of the department’s ambulance transport calls are for Medicare patients, and the costs of supplies alone can total more than Medicare pays. In The Dalles, average cost is $625 with average reimbursement at $350.

Walden’s Medicare Ambulance Access, Fraud Prevention and Reform Act, which has bipartisan support, would give the departments the certainty of extra payments of 2 percent in urban areas, 3 percent in rural areas, plus bonuses in super rural areas. Redmond Fire’s coverage area includes three ZIP codes, one rural and two super rural.

The bill would pay for itself by establishing controls on fraud connected with nonemergency transport for patients with end-stage renal disease. Walden’s office said the Centers for Medicare and Medicaid Services has identified a significant increase in such dialysis transports, and his bill would build on existing programs in other states that use advanced authorizations to control related fraud.

It’s poor public policy to shift costs from Medicare to local rural fire departments by establishing inadequate reimbursement rates for ambulance transport. Walden’s bill doesn’t fix that underlying cause, but it does give local providers more certainty in their budgeting, and that should help alleviate the most immediate and troubling results. The bill deserves congressional support.