Medicare Payment Pause Threatens Morgan County Ambulance Services
A federal government shutdown has paused Medicare processing and payments for ambulance claims, putting rural providers like Echo Response EMS at financial risk and raising concerns for Morgan County residents. With about 31 percent of Morgan County enrolled in Medicare, interruptions in payments could strain local emergency medical services and disproportionately affect older residents.
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A pause in federal Medicare processing during the ongoing government shutdown is creating uncertainty for rural ambulance services that rely heavily on Medicare revenue, local providers and state officials warn. Echo Response EMS, which serves parts of Morgan County and west central Illinois, is holding Medicare claims filed after October 31 while staff and leaders wait to see whether payments and a statutory rural 3 percent add on will be honored.
The Illinois State Ambulance Association emphasized the stakes for rural providers, noting that "With more than 60% of ambulance service revenue dependent on Medicare payments, this shutdown threatens to choke off the financial lifeline that keeps ambulances on the road." The association also noted that "In past shutdowns, Medicare base payments continued even when add on adjustments expired," a pattern that appears to have changed this year as federal payment processing was curtailed.
Locally the numbers underscore the vulnerability. About 31 percent of Morgan County residents were enrolled in Medicare in 2024, higher than the west central Illinois county average of 28 percent. That concentration of older adults means a larger share of ambulance transports in Morgan County are billed to Medicare, and any disruption in payment flow can meaningfully affect small EMS providers that operate on thin margins.
Danny Kloever, president and owner of Echo Response EMS, described how his company is managing billing risks in the near term, saying "Basically, if we receive payments, and then they (the government) go back and they decide that they’re not going to keep that 3% add on, well then, potentially that could create a big problem for our billing department." Kloever said the service has not yet reduced coverage, adding "At this point, we haven't felt the effect of it yet." He warned that the consequences could materialize if the shutdown continues, explaining "But I believe that, if this doesn't get turned around like in another month or two, it will start catching up, and then it's going to become a significant problem very quickly."
Emergency medical services are a critical layer of the local health system. Service cuts or slower replacement of vehicles and staff would increase response times, place added pressure on hospital emergency departments and deepen health disparities for older adults, people with mobility challenges, and residents with limited transportation options. Rural communities face higher baseline risks from workforce shortages and longer distances to care, making reliable EMS funding a public health priority.
The Illinois State Ambulance Association is urging Congress to resolve the shutdown and restore regular Medicare processing. For now providers and county health officials are monitoring the situation closely while trying to safeguard daily operations. Kloever emphasized community commitment, saying "For our company, our focus is the community and we're not going to allow this to affect how we operate daily," and advised residents not to assume they will be denied transport because they use Medicare.
As Washington negotiates reopening the government, Morgan County health planners and EMS leaders say they will continue contingency planning to protect service continuity for the county's large Medicare population and to ensure equitable access to emergency care.