Sometime this year, the BWI Marshall Airport fire and rescue department will begin billing people for ambulance rides to the hospital.
The move, dictated by the General Assembly last year, follows a statewide trend to try to recover some emergency medical costs from insurance companies. Montgomery County, the state's most populous jurisdiction, began charging Jan. 1.
"It's become pretty standard in the aviation industry and in EMS in general," said Paul Wiedefeld, the airport's executive director. "We will mirror as much as possible Anne Arundel County and adopt a similar fee structure."
BWI is expected to submit its proposal to state lawmakers on Jan. 16. If it is accepted, officials would hire a third-party agent to manage fee collection, with an anticipated summer roll-out of the program, Wiedefeld said.
Anne Arundel, which provides more than 40,000 rides a year at a cost of nearly $100 million, implemented a flat fee in 2009. The $500 charge has generated an average of $6 million in revenue annually, with a collection rate of 30 percent, according to fire Chief John Robert Ray.
Ray called the system "a success" when he testified last year before the Montgomery County Council as it prepared to vote on fees.
Anne Arundel residents do not pay any portion of the fee not covered by insurance. Medicaid, Medicare and most private insurance policies already allow for reimbursement for the service.
It costs about $10 million a year to run the airport fire and rescue service. The Maryland Aviation Administration capital budget for fiscal year 2013 includes nearly $4 million in equipment purchases, and its long-range plan includes expansion of the fire station off Route 170, construction of a fire training facility and construction of a second fire station closer to the BWI terminal, according to the Department of Legislative Services.
In a report last year, legislative budget analysts said that the BWI fire and rescue service responded to 3,793 calls in 2011, with 1,290 of them coming from surrounding jurisdictions with mutual aid agreements.
The report said a fee could raise $250,000 annually and recommended that airport officials establish a framework for management and collection.
Reagan National Airport and Dulles International Airport already charge fees for service, as do 18 of the 23 counties and Annapolis and Baltimore.
But that's not to say the fee has been welcomed across the state. Montgomery County voters in 2010 rejected a ballot initiative authorizing a fee, but the county council ignored the opposition and in May approved a fee that ranges from $300 to $800. It is projected to raise $18 million.
Volunteer firefighter companies opposed the fee, saying it would make residents hesitant to call for assistance.
In the weeks leading up to the new fee, Montgomery County launched an information campaign featuring a letter to residents from County Executive Isiah Leggett and announcements on cable TV with assurances that no one would be denied service.