Ambulance companies are suffering major financial losses in the coronavirus pandemic because of an interaction between state government regulations and Medicare payment policy.

In an effort to combat hospital overcrowding during the coronavirus pandemic, states have required ambulances to treat patients at home if possible. Yet Medicare only reimburses ambulances when they transport a patient to a hospital, and most private insurers follow Medicare’s lead. This Catch-22 has cut deeply into ambulance companies’ revenues during the pandemic.