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Emergency services say Medicaid —tailored plans— have stalled $2.3M in EMS claims
Summary
Durham County emergency-services leaders told commissioners that changes to North Carolina—s Medicaid (tailored plans) have left roughly $2.3 million in EMS claims unprocessed by the administrator (Alliance), depressing FY25 revenue and complicating staffing and vehicle plans.
Tracy DeShazo, speaking for Durham—s emergency services leadership, said the state—s Medicaid transformation and the introduction of —tailored plans— on July 1, 2024 have created billing complexities that left approximately $2.3 million in EMS claims unprocessed by the administrator, Alliance. "We have approximately $2,300,000 in the pipeline that we're actually trying to get through," DeShazo said, adding that the funds could normalize in FY26 if claims are resolved.
Mark Lockhart, Director of the Office of Emergency Services, told the board EMS call volumes have risen 24.7% since FY18 and that the department is holding 4—5% of calls weekly (average hold about 31 minutes). Lockhart said the department has requested five replacement ambulances (delivery timelines 30—36 months) and 12 staffing positions (six EMTs, six paramedics) to staff one additional 24/7 unit; commissioners asked for additional data on call-location impacts and the intersection of development growth with EMS demand.
