Supervisors Advance Plan To Charge Fee For Ambulance

County to Study How To Structure Levy

Another revenue source is on the horizon for Prince William County as officials push forward with a long-discussed proposal to charge fees for emergency medical services.

"This is common practice not only in the commonwealth but across the nation," said Prince William Fire and Rescue Chief Kevin McGee, noting that Loudoun County is the only other area jurisdiction that doesn't recover fees. "If we do EMS billing, we will not deviate from providing the best care to patients. . . . Patient care will always be first and foremost, and nobody will be denied service."

On Tuesday, the Prince William Board of County Supervisors gave fire officials the go-ahead to begin the second of three phases designed to evaluate the possibility of charging Medicare, Medicaid and insurance companies for ambulance runs in the county. The uninsured would not have to pay, but the county is studying whether to charge a co-payment for the insured.

The board unanimously endorsed moving forward after members were briefed on an EMS billing feasibility study. The roughly $60,000 study, conducted by the EMS law and consulting firm Page, Wolfberg & Wirth, addressed the financial, logistical, political and legal feasibility of implementing fees.

Supervisors brought the issue up nearly a decade ago, but after months of discussion scrapped the idea and directed county staff members not to raise the issue again unless the board requested it. And recently, as supervisors and county officials look at new ways to bring in revenue, it did.

"The fact is today if someone requires an [EMS] service, the taxpayer pays for that service," said board Chairman Corey A. Stewart (R-At Large). "The only entities getting away with something [are] insurance companies, Medicare and Medicaid."

The study projects that Prince William will recover $3.1 million the first year of EMS billing. The five-year projected gross revenue stands at more than $21 million, though the exact projections will depend on the billing schedule drafted by the county. The revenue would "in no way" cover the total cost of operating ambulance services, the report said. It would, however, lessen the burden on county taxpayers.

Based on current data, the study suggests that Medicare will pay the county 80 percent of a claim that falls between $216 and $595, and Medicaid will pay 80 percent of a claim that falls between $150 and $721. McGee said as part of phase two, fire and rescue officials will have to set ambulance fees, which will vary depending on the level of care EMS technicians provide. The county will need to decide whether to require co-pays, but many counties waive co-payments, considering taxpayers already contribute to fire and rescue services, McGee said.

The Greater Manassas Volunteer Rescue Squad began billing for emergency medical services almost three years ago, said Leon Buckley, captain with the Manassas Fire and Rescue Department. The city charges about $300 for basic life support and $470 to $550 for advanced life support.

Buckley said that nobody is required to pay out of pocket and that those without insurance don't pay. All the money from the program -- about $400,000 annually -- goes back to the volunteer squad.

Besides drafting a fee schedule in phase two of the EMS Billing Program initiative, McGee said, his department will train all EMS technicians, develop a complete policy, submit applications to Medicare, Medicaid and insurance companies, promote a staff member by year's end to oversee the efforts and raise public awareness.

"Political feasibility is a question of engaging all stakeholders," said Doug Wolfberg of the consulting firm. "I'm confident if accurate information is disseminated, taxpayers and you will see this is a good move."

McGee said that once a final policy is complete, he will go before the board again for approval -- something he hopes will happen within the next year.