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Monday, June 30, 2025 at 8:33 AM
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VA Rule will Hurt Rural Veterans

As a practicing physician in rural Nevada, I can tell you that healthcare is challenging in rural areas all around the U.S.
VA Rule will Hurt Rural Veterans

This article was updated on October 13.

Ground and air ambulances are a lifeline for millions of veterans across the U.S., ensuring they receive the health care they deserve in a timely manner. For the 254,851 veterans in Nevada, access to health care is already challenging, especially for those veterans living in rural Nevada.

Over the years, the emergency medical services industry has delivered care to thousands of veterans, especially to those living in rural areas like ours. The industry’s specialized teams provide more than medical transport; they can be the difference between life or death for a veteran.

As a practicing physician in rural Nevada, I can tell you that health care is challenging in rural areas all around the U.S. Since 2010, 138 rural hospitals have closed across America: 19 hospitals closed in 2020 alone. Nevada has lost two rural hospitals in recent years, representing a reduction in available medical services for thousands of Nevadans.

This is why I’m concerned about a rule change by the Department of Veterans Affairs to cut reimbursement rates for ambulance services at or below Medicare rate. This rule will especially hurt veterans living in rural areas like Fallon where they don’t have easy access to a VA facility. 

This move will close critical links in the health care chain, which enable those in remote areas to access traditional and emergency care in a timely fashion. If implemented, this rule will substantially reduce rural ambulance capacity, harming veterans by limiting access to lifesaving medical care.

The new rule will also deny payment if a veteran is transported to a non-VA facility.  This will impact Fallon veterans who may need to get to Banner Hospital quickly, versus the longer drive to the Reno VA. 

Considering that more than a quarter of all U.S. veterans (4.4 million) live in rural areas around the U.S., this rule would significantly reduce the ability of the elderly and disabled to access health care. Reflecting on what all these veterans have done for our country, this is not the treatment they deserve.

I urge Nevada’s Senators and Representatives to support Senate Bill 2757, the VA Emergency Transportation Access Act. This bill will ensure proper review of the actual costs of transport and that new rates are confirmed to reflect the actual costs of transportation. That is a fair and reasonable action to take. It also creates a forum for air and ground medical service providers to engage with the VA on future reimbursement rate modifications. This will protect veteran’s access to emergency transport in the future!

Dr. Robin Titus is a practicing family physician, Chief of Staff at South Lyon Medical Center, and a state Senator representing District 17.


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C Comment author: Carl C. HagenComment text: What are MFNs and PBMs ?? ............................ From the editor: This is a very good question and we apologize for not catching that wasn't in there. We reached out to the writer/submitter and got this info back...hope it's helpful. PBM: Pharmacy Benefit Managers are pharmacies that are owned by insurance companies. (CVS is one.) They negotiate with drug makers to get reduced pricing for medications, but they historically have not passed along those savings to patients. https://www.ftc.gov/system/files/ftc_gov/pdf/pharmacy-benefit-managers-staff-report.pdf MFN: Most Favored Nation pricing is a policy that means a country agrees to offer the same trade concessions (like tariffs or price reductions) to all member nations of the World Trade Organization (WTO). When applied to pharmaceuticals, it could disrupt global access, deter innovation, and obscure the deeper systemic issues in American health care. https://petrieflom.law.harvard.edu/2025/05/22/the-global-risks-of-americas-most-favored-nation-drug-pricing-policy/Comment publication date: 6/23/25, 7:47 AMComment source: L E T T E R TO THE EDITORComment author: Debra J RidenourComment text: So sorry for your loss. My condolences to the family.Comment publication date: 6/21/25, 7:25 PMComment source: Obituary - Ronald Warren Biggs K Comment author: Kim RawlingsComment text: well then vote them out next timeComment publication date: 6/20/25, 2:21 PMComment source: Spross Hired as County Manager After Split Vote, Updates Commission on Current ProjectsComment author: Chris GarrisonComment text: Congratulations Hornets and to Bryce Timmons for making Allstars! I’m a very proud Grandma! ♥️Comment publication date: 6/20/25, 1:39 PMComment source: Fallon Hornets Compete at Youth Nationals Baseball Tournament
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