Tuesday, October 5, 2010

Ambulance Reimbursement

As many of you are aware the Maryland Court of Appeals recently ruled that the question of Ambulance Reimbursement be included on the ballot in November. Thus all of you out there who reside in this wonderful community called Montgomery County will have an opportunity to vote, November 2nd, on this very important public safety initiative.

What many of you may not be aware of are the actual particulars of the Ambulance Reimbursement program. Unfortunately, I have heard many well intentioned folks make statements that simply do not accurately portray what Ambulance Reimbursement is all about. The fact is a majority of our neighbor’s in jurisdictions around the Metro region are already collecting tens of millions of dollars in ambulance reimbursements from Medicare, Medicaid and health insurance companies – with NO adverse effects on residents calling 911 and NO resulting premium increases.

Obviously, there are many other aspects of the reimbursement program that you should be aware of. Toward that end, I am posting links below to information you might find useful as you learn more about the reimbursement program.

As always, Be Safe!

The case for ambulance service fees (from the Washington Post 10/4)

Get the facts about County Ambulance Reimbursement

Ambulance Reimbursement

It's All About Saving Lives...(English pdf      Spanish pdf)


KatieSilverSpring said...

how do you see Medicare and Medicaid reimbursements as not effecting those you use an Ambulance-Reimbursed program? what do you see as the source of Medicare funding? Taxpayers pay for it, so while I may not take it out of my pocket at the time of use, I will when Medicare contributions go up.

And, why is a county-financed email service being used to promote what is a political position on an upcoming voter referendum?

Anonymous said...

Chief, There is one related issue that needs to be clarified and perhaps fixed for us to be able to support the initiative wholeheartedly: I understand that our hospital intensive care units give priority to patients arriving by ambulance. Therefore, there have been many unnecessary uses of ambulances when personal car would be adequate transport. Please use your strong influence to get this priority system changed to one of fair immediate triage of all patients entering ERs.

billd said...


There is no such priority given nor has there ever been. By law all the treatment patients are given is based upon their medical problem and its severity. The fact that you get seen sooner or receive better treatment if you arrive by ambulance is one of those urban myths.

Geoffrey D. Burns said...


I for one am in the minority on the volunteer aide in MCFRS who thinks we need this initiative. The problem I have is that the way the law is written, paragraph (h) says the except for the transfer from the general fun, and in the first fiscal year of implementation, this won't be used to supplant or replace funds already received in the normal budget.

What about after the first year?

We need the money, we need the support an items the money will allow. But, the question is, will it end up being like the Fire Tax which goes into the General Fund?

I can see the powers that be saying 'Well, you get $14M so we'll just take that much of your budget.' that is where I have an issue with the bill. If it said that the money would come to MCFRS EVERY year, no problems.

Anonymous said...

I strongly dispute billd's claim. On the multiple trips to the ER for my mother while she was battling cancer, she absolutely was seen immediately when she arrived via ambulance as compared to when I drove her there myself. And if billd tries to argue that her condition was less serious when I drove her there myself, that was not the case on several occasions, yet we had to wait, because she had not arrived via ambulance.

gail said...

I do not understand why fees are being assessed to the VOLUNTEER stations -- they ALREADY ARE FREE !! They are 501C3s and they raise their own funds to sustain their houses. This all appears to me to -- once again -- about UNIONS IN MONTGOMERY COUNTY putting a strangle hold on our wallets !!
Charging Medicare / Medicaid or private insurance for an ambulance ride which is FREE due to the fabulous volunteers seems inappropriate, to say the least.

Anonymous said...

Getting to a hospital via ambulance does NOT give anyone priority. I was taken by ambulance to Shady Grove, a few years ago, by ambulance after being hit from behind, while I was stopped. I begged to go to Suburban or Holy Cross, but, the ambulance driver REFUSED to take me, even though the other ems guys asked him to. After being in the er for 2 hours,on a hard board, with my neck in a tight collar, having had two asthma attacks, and not seen by any doctor, my husband was notified by the police because the hospital refused to call him, or my own doctors, my husband helped me out from the hard board and the collar. WE LEFT. Yes, that's right we left. So, if anyone things coming to the hospital, at least Shady Grove, by ambulance gives you priority, is most definitely a HUGE MYTH.

billd said...

2nd Anonymous,

First, I hope your mother is doing fine as that must be a horrible experience and one I pray I never have to go through with any of my parents.

I stand by my comment. What you ran into was the fact that they will bring you back into the ER area when you arrive by ambulance. Once there, you are assessed as if you walked in the front door. It just seems different since your mother was wheeled back into the area when arriving by ambulance verses having to be assessed in the waiting area. After that, all things are equal.

Also factor in how busy was it when your mother arrived each time? What types of injuries/illnesses were there at the time. How many life threatening? All of that factors into when you get seen. I obviously could not tell you she was less serious when going with you as I was not there. The doctor and/or triage nurse determines that.

billd said...


The vast majority of EMS calls are run by our career staff. Even a medical call run by an all volunteer crew is not free. You need equipment, gas, uniforms for people, plus wear and tear on vehicle that requires maintainance, etc., etc.

Montgomery County also provides many of the volunteer stations funding to help with their operating expenses. Many of the vehicles have been purchased by Montgomery County taxpayers.

billd said...


First let me just state that I am NOT promoting a political position. I did not tell anyone to vote one way or another. I am merely relaying fact based information as, sadly, there has been a lot of misinformation put forth by others.

I believe if you click on the links your question re medicade/medicare funding will be answered. I will say that this is something you and all other folks have been paying for years as medicare/aide had factored in ambulance transportation into their (your) premimums.

Thus, by not availing ourselves to this fund that all insurance companies make you pay for anyway, we are all merely SUBSIDIZING the medical insurance industry if we do not charge. Your call and right as a voter is to decide where you want that money, you are and will always pay, to go.

billd said...


I will have to ask someone else about your question as I am not aware that is the case. Will try and get you an answer as soon as I can.

Anonymous said...

Gail, I don't know if you have any connection to Mnot. Co. Fire and Rescue or know how it works, but the word "Volunteer" doesn't mean free here. The volunteers in Mont. Co. have, in essence, their own union as they have bargained with the County twice and have a signed contract with the county just like the career fire fighters, police, and the other unions. If the volunteers meet certain requirements during they year, they get a paycheck at the end of the year, and throughout their tenure as a volunteer, they may qualify for what is, in essence, a retirement check. Before you start bashing unions, and use the words "free" and "volunteer" in the same sentence, do your homework. The ambulance fee is not a career/volunteer issue, and it is not a political issue, it is a BUDGET issue. It would be wonderful if people would start to understand that. It has never been us vs them, but the volunteers have tried to make it that way.