Stop the Medicaid ambulance grift
A little-known accounting trick has turned paying for an ambulance into a bloated scam
My recent article, featured in The Spectator World, which explores an interesting grift in regional - and national - healthcare.
With Congress back in their districts for the August recess, GOP members will undoubtedly be bragging to their base about the Medicaid abuses they stopped by passing President Trump’s One Big Beautiful Bill. These reforms include enrollment reductions and new work requirements for enrollees.
However, many Members are hoping that no one calls them out for failing to address an intergovernmental transfer grift. This little-known accounting trick has turned this basic entitlement program into a bloated scam that enriches public agencies while squeezing out private providers.
In theory, many of the services Medicaid covers, such as emergency ambulance rides, officially known as Ground Emergency Medical Transport (GEMT), should be straightforward. Someone calls 911, an ambulance arrives and someone gets paid. It should be a clean transaction, one that reflects the actual cost of service. But that is not what happens.
The problem starts when public ambulance agencies file inflated cost reports to state Medicaid offices, claiming that a single ride costs as much as $1,600. In reality, private providers perform the same service for about $339. The state uses the inflated figure to extract extra federal funding, then hands the surplus to local governments. None of it improves care. It is a rigged operation that rewards false accounting, punishes honest providers and burns through taxpayer dollars.
Many of these public entities do not even operate ambulances. They subcontract the work to private companies, then skim the excess funding for unrelated local spending.