Anne Arundel County Council members looking to cash in on the rising number of emergency medical calls are expected tomorrow to pass a new measure in next year's budget that will charge $500 for an ambulance ride to the hospital.
If passed, the measure will take effect on April 1, 2009, and apply to all emergency medical transports, regardless of the patient's injuries.
Council members said most of the cost will be absorbed by insurance companies, which already cover similar costs in other Maryland jurisdictions, but questions remain on how co-payments or deductibles will apply to county residents or how - or whether - the fee will be levied on the uninsured.
"I want to make it clear that no person will ever be denied emergency services transport regardless of their ability to pay," said County Executive John R. Leopold, who proposed the measure in his $1.2 billion operating budget and $214 million capital budget May 1.
Battalion Chief Matthew Tobia, a spokesman for the Anne Arundel County Fire Department, said 15 other Maryland jurisdictions have similar fees in place, in some cases for decades.
Baltimore City has had an ambulance fee since 1989 and charges $420 for anyone transported by ambulance to the hospital, said Kevin Cartwright, a Baltimore City Fire Department spokesman. Prince George's County has had a fee of $250 for paramedic service since 1985, but that will jump to as high as $700 for patients in cardiac arrest when new legislation goes into effect July 1, said Mark Brady, chief spokesman for the Prince George's County Fire and Emergency Medical Services Department. Prince George's will also impose a cost of $10 per mile to the hospital, Brady said.
In Anne Arundel, the new fee will generate $8 million per year and will be the largest source of new revenue in the county's budget, since legislators last week rejected Leopold's plan to raise the county's hotel tax.
Tobia said that in 2007 the county transported 44,000 people to hospitals, up from 32,000 in 2006; the number of trips was not available. Tobia said the increase puts a "significant" demand on a system that includes 20 paramedic ambulances and nine basic life support ambulances. He said that other counties with an ambulance fee haven't seen a drop in calls.
Councilman Joshua J. Cohen, an Annapolis Democrat, said that health insurance companies include such costs in their premiums and that it is time for the county to tap into them.
"Health insurance companies are already prepared to pay that fee, and they pay it in many other jurisdictions," Cohen said. "Taxpayers are, in effect, subsidizing the insurance companies, because the taxpayers are paying for an ambulance service that insurance companies are willing and able to pay for."
Council members and fire department officials said that they are discussing how to deal with co-pays or other deductibles that might be required by the insurance companies and that they have not ruled out waiving them.
Tobia added that the county would not seek any portion of the fee from patients. Medicare Part B, for example, covers 80 percent of ambulance fees, but Tobia said the county will not seek the extra 20 percent from the patient.
Some on the council said they worry that just the perception of a fee for EMS services could deter sick residents from calling for an ambulance.
"I don't want it to dissuade seniors and people on fixed incomes from calling an ambulance if they need to," said Councilman Daryl D. Jones, a Severn Democrat, who said they would need a major public awareness campaign.
Council members said they were working on how to account for uninsured patients who cannot afford the transport bills.
John R. Hammond, Leopold's budget officer, said the projected $8 million in annual revenues is based on a 50 percent recovery rate, adding, "We not going to be banging on people's doors to collect."