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GET THE FACTS: About the Emergency Transportation Insurance Reimbursement

Check out the following sources of information on the new law:

The Emergency Medical Transportation Insurance Reimbursement website

What hired petition gatherers are distributing -- chock full of inaccuracies. Check it out (pdf).

News release: Leggett Hails Council Approval of New EMS Insurance Reimbursement Legislation

Gazette editorial: “The right vote”

CATEGORIES: EMS
POSTED: Friday, July 20, 2012 | 6:00:00 AM |

Leggett Praises Council’s Approval of the “Emergency Medical Transportation Insurance Reimbursement Act”

County Executive Ike Leggett has praised the County Council for approving the “Emergency Medical Transportation Insurance Reimbursement Act” during its May 15 session.

Under the act, the County would recover approximately $18 million a year in Emergency Medical Services costs from insurers and the government at no cost to County residents -- whether or not they have health insurance. County residents would not even get a bill.

Currently, all costs for the County Fire & Rescue Service are borne entirely by County taxpayers.

Leggett said, “This legislation will help strengthen our Fire & Rescue Service and is good for the taxpayers. I want to thank the career and volunteer Fire & Rescue personnel who have written to me and spoken out in favor of this legislation.

"The Montgomery County League of Women Voters recommended approval of the legislation, in addition to the Western Montgomery Citizens Advisory Board and the Montgomery Democratic Party that overwhelmingly supported the legislation.  The latter two groups had previously opposed the law.  Other groups in the County also weighed in to support it once they had the chance to fully evaluate the law on its merits.

“The State of Maryland has recently decided to shift to Montgomery County what could very well be more than $400 million over 10 years in state teacher pension costs,” Leggett said. “The State has also approved a new ‘Maintenance of Effort’ law on school funding that could force us to add millions more to our reserves each year above and beyond what we already do.

“These are changed circumstances of monumental significance, ones that were not before the voters in 2010 when the referendum on the County’s EMS reimbursement program occurred,” Leggett noted.

“I believe,” the Executive said, “the evidence is clear that either you allow the County to request reimbursement from insurance companies and the federal government from premiums already paid to them -- just as nearly every other jurisdiction in the region does – or you raise taxes, or you cut services already reduced severely over the past five years.”

“Since 2010, Anne Arundel County in Maryland and Prince William County in Virginia have joined nearly everybody else in the region in authorizing insurance reimbursement – collecting millions of dollars with no evidence of adverse effects,” said Leggett. “Montgomery County should do the same.”

This legislation is different from the law before the voters in 2010 in several important ways. This version:

  • Specifies that County residents pay no out-of-pocket expenses relating to any County EMS transport;
  • Prohibits Fire & Rescue Service personnel who respond to a request for emergency transport from seeking any insurance information from those being served;
  • Establishes an Emergency Medical Services Patient Advocate in the Office of Consumer Protection;
  • Requires the Fire Chief to report on a semi-annual basis to the County Executive and County Council on implementation of the Act; and
  • Requires a broad public education campaign as the program is implemented, especially focused on “New American” communities and County seniors.

“The proceeds from the insurance reimbursements would go to help strengthen our Fire & Rescue Service," Leggett explained. “And, of course, our Fire & Rescue Service will continue to serve all in need, regardless of ability to pay -- just like before.” 

Get more information about the “Emergency Medical Transportation Insurance Reimbursement Act.”

Read Councilmember Riemer’s letter of support.

Montgomery County Council Approves Emergency Medical Transportation Insurance Reimbursement Law (pdf)

CATEGORIES: EMS , County Executive , County Council
POSTED: Friday, May 18, 2012 | 8:30:00 AM |

“The right vote” -- The Gazette’s editorial, May 16, 2012

“The County Council made the right call Tuesday in approving County Executive Isiah Leggett’s proposal to resurrect a controversial “fee” for ambulance service — despite the fact that voters overturned a similar measure through referendum in 2010.

“Opponents of the bill — which consist mostly of volunteer fire companies whose members fear the legislation will soften their ability to raise money — have pledged to again take the measure to referendum.

“However, if the bill does go to referendum in November, voters likely will approve it this time. The firmer, 6-to-3 support of the council for the measure, along with a promised effort by Leggett to better inform the public what the bill actually does — as opposed to what opponents claim it does — should be enough to convince voters they have nothing to fear.

“As several council supporters of the bill made clear before the vote, the term “fee” is a misnomer. Montgomery County residents already pay for ambulance service through their taxes and through the premiums they pay to health insurers

“The bill will not require county residents having to cough up cash for an ambulance ride. It merely allows the county government to seek reimbursement from insurance companies for the cost of ambulance rides, just as hospitals seek reimbursement from insurers for treating patients.

“Nearly all of Montgomery’s neighboring jurisdictions collect such reimbursements for ambulance service, while Montgomery effectively leaves that money sitting on the table. The only people who would directly pay for ambulance rides in Montgomery would be out-of-county residents who have no insurance, though they would be eligible for a hardship waiver.

“Billing insurers would generate roughly $72 million over the next four fiscal years that the county otherwise wouldn’t collect, according to the executive’s office. That money would go to the county’s fire and rescue service.

“Critics of the bill — particularly County Councilmember Phil Andrews — have accused Leggett of disregarding or circumventing the people’s will by reintroducing the bill less.

“But Leggett rightly pointed out when he resurrected the measure in April that the county’s fiscal situation has changed since the vote. Most importantly, Montgomery is facing the cost of shouldering a larger chunk of the cost of public teacher pensions, which the state historically has paid.

“(The General Assembly was working out the details of the pension shift in this week’s special session in Annapolis; during the regular General Assembly session, Leggett estimated the shift would cost Montgomery $125 million in the next three fiscal years.)

“In explaining their vote on the bill, several supporters on the council said they were swayed by amendments Leggett offered that would create an education campaign designed to explain the legislation to residents and a patient advocate in the Office of Consumer Protection to handle complaints and service problems related to the reimbursement.

“Several also criticized what they called a ‘misinformation’ campaign opponents mounted during the 2010 referendum battle that sought to convince voters that passage of the bill would mean that residents would be forced to pay out-of-pocket fees for ambulance rides.

“Leggett clearly learned lessons from the bruising referendum battle of 2010 and this time made an effort to meet some of the opponents concerns and to ensure that residents are clear about what the bill achieves — and, just as importantly, what it doesn’t.

“Kudos to the council for not bending to the false assertion that passage of this bill somehow subverts democracy in Montgomery County.”

CATEGORIES: News , EMS
POSTED: Friday, May 18, 2012 | 8:00:00 AM |

Leggett Proposes EMS Transport Reimbursement to Offset State "Tidal Wave" Cost Shift to County

Responding to the decision by the State of Maryland to shift hundreds of millions of dollars in costs to the County, County Executive Ike Leggett has proposed to the Council the “Emergency Medical Services Transport Reimbursement Act.” This legislation would allow the County to be reimbursed by private health insurance companies and the federal government for ambulance service, just as hospitals seek reimbursement from insurers for treating patients – and just as nearly every other jurisdiction in the region already does.

“As a County resident -- whether insured or uninsured -- you would not, by law, pay a dime,” said Leggett. “You wouldn’t even receive a bill. The County would accept the reimbursement offered as payment in full and would waive all co-pays and deductibles.

“And 100 percent of the reimbursements would be dedicated by law to meeting the critical and growing needs of our Fire & Rescue Service.

“Why am I proposing this? It’s simple.

“Montgomery County is about to be hit by a ‘tidal wave’ from Annapolis.

“The State of Maryland has recently decided to shift over $400 million over 10 years in state teacher pension costs to Montgomery County. The State has also approved an inflexible 'Maintenance of Effort' law on school funding that could force us to add at least $25 million to our reserves each year above and beyond what we already do.

“These are changed circumstances of monumental importance. These changes were not before the voters in 2010 when the County’s EMS reimbursement program was not approved.

“That is the reason why I am proposing this bill, which has already drawn broad support, including editorials in favor from the Washington Post and The Gazette.

“Either you allow the County to request reimbursement from insurance companies and the federal government from premiums already paid to them  -- just as nearly every other jurisdiction in the region does – or you raise taxes or cut services already reduced severely over the past five years.

“In fact, not having the millions of dollars in reimbursements could mean less Fire & Rescue staffing, less equipment and longer response times. That could jeopardize the health and safety of the public. That’s a real-life impact – not a vague hypothetical.

“Most jurisdictions in Maryland and Virginia and the majority of communities in the United States are recovering millions of dollars in costs from insurers – with no adverse impacts. No evidence of folks not calling 911 when they need an ambulance. No adverse effects on volunteer companies.  And no increase in insurance rates – that’s because the costs of emergency services – a minuscule bit of health care costs -- are already included in the premiums charged by insurers and paid by County residents. And, in most cases, the EMS reimbursement was supported by volunteers in those counties.

“The $180 million we would collect from insurance companies and the federal government would go a long way toward offsetting a significant portion of that $400 million-plus cost shift from the State.

“It would be irresponsible not to pick up $18 million every year that’s sitting on the table to be collected – without costing County residents one dime. The status quo puts the full burden of supporting our Fire & Rescue Service on the taxpayers. Sure, we could raise taxes and cut services – a lot – to meet the cost shift from the State but – really – why should we? That is the choice.”

The Council public hearing on the legislation will be held on May 8 with action by the full Council on May 15.

  • Post editorial in support of EMS Act (pdf)
  • Gazette editorial in support of EMS Act (pdf)
  • County Executive memo to the County Council and Act (pdf)
  • EMS Reimbursement Programs in Maryland, Virginia and National Capital Region Maps (pdf)
  • CATEGORIES: EMS
    POSTED: Thursday, April 26, 2012 | 9:00:00 AM |

    Question A: Here’s What the Ballot Looks Like

    On November 2, voters will have the opportunity to vote either for or against County Question A: Emergency Medical Services Transport Fee. Below is the sample wording for County Question A as it will appear on the ballot:

    What does this mean?

    A vote FOR will allow the County to bill residents’ insurance companies, Medicare or Medicaid for ambulance transport. County residents would not pay anything additional. Residents without medical insurance would not be billed. Montgomery County Fire & Rescue Service will continue to serve anybody in need, regardless of ability to pay.

    A vote AGAINST would mean the County could not seek reimbursement from residents’ insurance companies, Medicare or Medicaid for ambulance transport and the County would continue to pay the full cost for all. Montgomery County Fire & Rescue Service will continue to serve anybody in need, regardless of ability to pay

    CATEGORIES: Election , EMS
    POSTED: Monday, November 01, 2010 | 8:00:00 AM |

    Area Fire Chiefs Tout Successes of EMS Fees in Respective Jurisdictions

    Montgomery County Fire Chief Richard Bowers (at podium) was  recently joined by (from right to left in photo) Frederick County Assistant Fire Chief Richard Himes, Prince George’s County Fire Chief Eugene A. Jones, District of Columbia Chief of Fire and Emergency Medical Services Department Dennis L. Rubin; Stafford County Fire Chief J. Robert Brown, Jr. and Prince William County Assistant Fire Chief Brett Bowman to discuss the success of their Emergency Medical Services (EMS) revenue recovery programs.

    Montgomery County voters will decide on November 2 whether to approve County Question A, which will allow County Council Bill 13-10: Emergency Medical Services (EMS) Transport Fee to become law.

    See Washington Post article for details about Fire Chiefs support (pdf). See more info about Ambulance Reimbursement. For a video presentation go to
    http://www.youtube.com/watch?v=p9PT1xWmiww.

    CATEGORIES: EMS , Election
    POSTED: Monday, November 01, 2010 | 7:00:00 AM |

    Community Action Board Votes to Support Ambulance Fees

    The Montgomery County Community Action Board (“CAB”), which advises the government regarding the needs of Montgomery’s low-income people, voted at its October 26 meeting to support the passage of Ambulance Fees, concluding that low-income families would not be adversely affected by the passage of Ballot Question A.

    The CAB expressed its concern regarding the need to maintain funding for critically needed safety net services during a very difficult budget year. The board noted that it is not possible to further reduce the budget without seriously harming the County’s low-income and working poor families, who continue to struggle to make ends meet during this recession.

    CATEGORIES: EMS , Election
    POSTED: Monday, November 01, 2010 | 6:00:00 AM |
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    Last edited: 11/8/2010