Ambulance fee moves closer to reality

Crews rescue a car crash victim on Nokesville Road. Under a county plan, ambulance costs would be billed to residents' insurance, but no one would pay out-of-pocket.
Crews rescue a car crash victim on Nokesville Road. Under a county plan, ambulance costs would be billed to residents' insurance, but no one would pay out-of-pocket. (2009 Photo By Marvin Joseph/the Washington Post)
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By Jennifer Buske
Washington Post Staff Writer
Thursday, January 21, 2010

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

On Tuesday, the Board of County Supervisors endorsed policy recommendations that will be used by fire, rescue and county officials as they draft an ordinance and create an EMS billing program, something Prince William officials have discussed for decades but only recently pursued to bring new funds to a county strapped for cash.

Under the guidelines, the county would charge Medicaid, Medicare and insurance companies for ambulance runs. Tax revenue would cover anything not paid by a resident's insurance, and the uninsured would not have to pay.

Other recommendations adopted include billing non-county residents for their co-pay, drafting a waiver policy and outsourcing the billing process, which, Prince William Fire and Rescue Chief Kevin McGee said, is time-consuming and requires subject-matter experts he doesn't have on staff.

The ambulance fees, which the board approved, will probably be $400 for a basic life-support emergency and $500 to $700 for an advanced life-support emergency. A $10 per loaded mile fee would also be charged, according to county documents.

McGee said the ambulance fee recommendations are based on an EMS billing feasibility study conducted by the consulting firm Page, Wolfberg & Wirth last year.

That study also projected that Prince William could recover $3.1 million the first year of EMS billing and more than $21 million over five years. McGee, however, said the numbers are probably not completely accurate and will be discussed as officials finalize the billing program. Loudoun County is the only other area jurisdiction that does not recover ambulance fees, he said.

"What's happening in Prince William is insurance companies are getting away with not having to pay for ambulance transportation services," said board Chairman Corey A. Stewart (R-At Large).

With the approval from the board, McGee said the next step is to launch public and provider education programs and find a contractor to handle billing services. McGee said there will also need to be a public hearing and another vote by the board before any EMS billing program is adopted.

Also at Tuesday's meeting, the board decided to bring back the buses used to transport residents to and from the Manassas and Woodbridge senior centers.

The board unanimously agreed to reinstate part of the senior transportation program that fell victim to budget cuts last year. The program will include two part-time drivers and two buses that will run four days a week and serve about 60 riders a day, said Courtney Tierney, director of the Prince William Area Agency on Aging. The previous transportation program ran five days a week with six buses, she said.

Although the schedule isn't complete, Tierney said Mondays will probably be used to schedule pickups along four routes. Two routes will probably be active Tuesdays and Thursdays and the other two on Wednesdays and Fridays. People who live near a senior center might be able to be picked up all four days, she said.

Tierney said that $90,000 left from last year's budget cuts, plus $30,000 from the sale of one of the previous buses and $20,000 of Woodbridge district transportation funds from Supervisor Frank J. Principi (D), will cover the cost of running the program and buying two buses.

The program will probably begin in April and replace the voucher program started last year to keep some seniors mobile until a permanent solution was reached. Tierney said that no new vouchers will be distributed but that seniors can use any they have that have not expired.

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