Features

Montgomery County may begin to charge "Ambulance Fee"

Some EMTs worry that fee will dissuade people from calling 911

by Pamela Manning

There is a health emergency in your home: someone you love is acutely sick, or hurt, or bleeding, possibly in danger of physical harm that may be permanent—even fatal.  He or she needs immediate medical assistance.  An ambulance.  Now.

Would you think twice about calling for help if you thought you might be charged over three hundred dollars for doing so?  Would you attempt to transport your loved one to the hospital yourself, losing precious time in accessing critical care?  If you did call an ambulance, would you worry that responding emergency personnel would give less quality care, or even refuse to give treatment, if they knew you did not have insurance or the money to pay for their services?

Fears about the fee

The above are just a few of the potential public misperceptions that alarm opponents of the Ambulance Fee Reimbursement Proposal.  The Proposal, put forth by the Office of the County Fire Administrator, recommends a fee of approximately $350 for ambulance transports provided by the Montgomery County Fire and Rescue Service.  There is currently no charge to county residents for ambulance transports to hospitals, or for the services of paramedics.

According to Mike Livingston, a Volunteer Emergency Medical Technician (EMT) with the Takoma Park Volunteer Fire Department, "People wonÕt call 911 if they hear about the $350 charge.  Treatable problems will become untreatable, and people will die."

Livingston feels that the county would be sending a "grossly mixed message" by instituting a substantial fee for ambulance transport after traditionally encouraging citizens to call 911 "when in doubt."

County volunteer EMT Stephanie Seifried commented on the ambulance fee, "ItÕs bad PR [public relations].  There is a fear of service denial for those unable to pay." 

Understanding the fee

It is important to balance the legitimate concerns of Proposal opponents including volunteer emergency service providers, who are the first responders to medical crises in the community, with an awareness of the county governmentÕs position on instituting the ambulance transport fee.

Montgomery County Fire and Rescue Service spokesperson Pete Piringer says the ambulance reimbursement fee is actually an insurance reimbursement fee.  This makes it a third party fee: one that is not charged directly to the recipient of services. 

According to Piringer, "Insurance premiums cover this fee.  Insurance companies take this cost into account, and budget for it.  We have not been taking advantage of this revenue source, which would allow maintenance, improvement and enhancement of existing services.  Everyone providing emergency medical services would benefit from the fee." 

He emphasizes that there will be no change in response times or levels of care should the fee be implemented, and that the provision of emergency medical services is distinct from the billing of third parties for these services.

Piringer points out that numerous other jurisdictions in our region have been receiving third party reimbursement for ambulance transport services.  Among these are Prince GeorgeÕs, Baltimore, and Washington Counties, as well as Frederick, Arlington, and the District of Columbia.  Piringer also notes that in large metropolitan areas nationwide, such as Philadelphia, New York, and San Francisco, third party reimbursement for ambulance service has already been instituted.

Current status

The proposed increase in ambulance fees is not a new issue.  The County Council voted eight to one against a fee increase last year, but could not be reached for comment on this issue. 

Piringer says that revenue from an ambulance fee has not been included in the currently proposed county budget.

A public forum on the Ambulance Fee Reimbursement Proposal was held at on March 8, 2004.  Questions or comments about the Proposal should be directed to the Montgomery County Fire and Rescue Service at 240-777-2400.