Resources for Ambulance Fee Issue

From my peer, Ken Hartman (Director, Bethesda/Chevy-Chase Regional Center)

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As you know, the County Council approved the ambulance transport reimbursement legislation earlier this year, and included the anticipated revenue from it in the current (FY11) operating budget. Two weeks ago a court ruled that a question may be included in November’s general election ballot to affirm or repeal the law. Should the reimbursement fee be repealed the County will need to immediately account for the loss of revenue in the current fiscal year.

In light of a potential repeal, County Executive Leggett has proposed a savings plan for this current budget year that eliminates or reduces projects and services in order to make up the projected $14 million that would be realized with the implementation of the ambulance reimbursement fee.

Should ambulance reimbursement be repealed, the County Council will have the final approval on specific budget reductions. Below is a link to materials and facts that might be helpful as you talk with neighbors, friends and family about the ambulance reimbursement fee. You’ll find a brochure, a Washington Post editorial, and a flyer listing the pros and cons. Feel free to distribute the material.

Washington Post Editorial

Link to County's on-line information

Facts about the Ambulance Reimbursement Fee

Ambulance Reimbursement will raise $14-$17 million a year in revenue that will be dedicated to maintaining and enhancing Montgomery County’s world-class emergency medical services.

County residents will not pay anything. Ambulance reimbursement will be billed directly to residents’ insurance companies, which have already factored the cost of patient transport into their rate schedules. Ambulance reimbursement will be waived for uninsured residents and will be covered by their tax dollars.

Montgomery County is one of the few jurisdictions in the region that is not already collecting ambulance reimbursement from insurance companies. Fairfax County collects the fee, as well as Frederick, Prince George’s, Carroll, Charles, Arlington, Washington, and Prince William counties. Cities such as Alexandria, Baltimore, and the District of Columbia also collect ambulance reimbursement. (see maps)

There is no evidence that those in need of transport will be dissuaded from calling 911 because their insurance is going to be billed or because they are uninsured. In the jurisdictions that have been collecting ambulance reimbursement, there is no evidence of that happening. Montgomery County will fund a public education campaign to make sure that residents know there are no charges to them for emergency medical services and no changes in service.

There is no evidence that ambulance reimbursement will raise insurance rates. Ambulance bills are in the “hundreds” of dollars, compared to hospital, physician, surgeon, rehab, device, and drug bills, which are typically in the “thousands and tens of thousands.” Ambulance expenditures account for less than 1 percent of insurance expenditures. Since most insurance companies determine rates on a regional basis – and most jurisdictions in the region bill insurance companies for this charge – in most cases County residents may already be paying for ambulance service as a part of their premiums.

The quality of patient care will continue to be the highest priority for Montgomery County’s Fire & Rescue Service. A resident’s ability or non-ability to pay will never be considered when providing service.

When a resident makes that 911 call, the first priority will be to take care of that patient’s immediate medical needs. If deemed necessary, the patient will be transported to the hospital. If not, ambulance reimbursement will not be charged to the insurance company.

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