People who need medical help from Ashland Fire Rescue paramedics but who are not transported to a hospital will have to pay a $250 fee.




Earlier this week, the City Council unanimously approved the fee.




The fee has actually been part of Ashland Fire Rescue's rates since 1996, but the department has not charged the fee until now, said Fire Chief Keith Woodley.




"We're just starting to charge because of the losses we're sustaining from Medicare and Medicaid losses," he said.




Ashland taxpayers have to make up ambulance service financial losses, he said.




The city-run ambulance service is losing money because of low Medicare and Medicaid reimbusement rates for ambulance trips. Of ambulance patients in the service area, 57 percent have Medicare. The ambulance service can recover only half of the bill from Medicare, EMS Division Chief Greg Case told Citizens Budget Committee members during the spring budgeting process.




Another 8.8 percent of ambulance patients have Medicaid, which only reimburses one-third of the bill, he said.




Some cities have private ambulance service, but those services are essentially subsidized by fire departments, which send paramedics as the first responders to scenes, Case said.




If the city had no paramedics, a private ambulance would reach the scene of an emergency in about eight minutes. Ashland Fire Rescue paramedics respond in four to five minutes, Woodley told budget committee members.




Woodley said this week that charging the $250 fee is not likely to cause people to not call for ambulance service when they really need help.




People who call 9-1-1 for emergencies already get screened to try and prevent unnecessary ambulance trips. Mercy Flights also charges the fee when it treats people but doesn't transport them, and that organization hasn't found that people who need help fail to call, he said.




Woodley said the $250 fee will only be charged when someone requires medical aid but is not taken to a hospital. Examples include diabetics who need insulin from paramedics but then stabilize and don't need to be transported, or people reporting chest pains who get monitored with equipment and turn out not to be having heart attacks.




Ashland Fire Rescue will not charge the fee when it provides non-medical help, such as aiding someone who has fallen and needs help to get up, Woodley said.




When people are transported to a hospital, the ambulance service bills people's health insurance.




The city does offer an ambulance service membership program. For $52, a household can sign up for a year of coverage, which covers everyone in the home. The City Council approved raising the annual membership charge from $40, the first increase since the program was established in 1996.




According to the city of Ashland's Web site, "The goals of the program are to overcome patient hesitance to call when medical emergencies occur, and to defray patient medical treatment costs within the ambulance service area."




For households that subscribe to the program, Ashland Fire Rescue agrees to bill the patient's insurance and accept the insurance payment. The ambulance service will not bill the patient for charges the insurance company doesn't cover.




Woodley said the program covers instances when a patient must be transported to a hospital. It does not cover cases when medical help is given but the patient is not transported.




"We don't want people to be using the ambulance for minor things," he said.




If the membership program covered treatment for things like bandaging abrasions, people would begin calling the ambulance for minor treatment. That would tie up an ambulance which might be needed for a real emergency and would also cause the city to have to hire more emergency workers, Woodley said.




Open enrollment for the ambulance membership program is from Sept. — through Oct. 31. Applications are accepted at any time of the year, but the program is not pro-rated.




For more information, call Ashland Fire Rescue at 488-6009.




Staff writer can be reached at 479-8199 or vlaldous@yahoo.com.




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