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Home My WebLink About2000 06 26 Regular F Resolution 2000-13 Fee Structure for Medical Transport COMMISSION AGENDA ITEM F CONSENT INFORMATIONAL PUBLIC HEARING REGULAR X 26 June 2000 MGR ~PT -!Jf I . Meeting Authorization REQUEST: Fire Department requesting the City Commission approve Resolution Number 2000-17 establishing fee charges for the City's emergency medical patient transport service. PURPOSE: To request that the City Commission approve Resolution Number 2000-17 from information presented at the City Commission Meeting held on 12 June 2000 on a fee structure that is set by Medicare for reimbursement for medical transport. CONSIDERATIONS: A. December 11, 1995 - Regular Meeting City Commission The City Commission approved the Second Reading and Public Hearing by motion Ordinance No. 608 authorizing the provision of Emergency Medical Services Patient Transport by the Winter Springs Fire Department. The fee charge for transport service for each person is hereby established as $184.63 per transport. B. August 11, 1997 - Regular Meeting City Commission The City Commission approved the Second Reading and Public Hearing by motion Ordinance No. 673 establishing the fees relating to the City's operation of the emergency medical patient transport system as follows: 1. Transport rate for a City resident of$185.00 2. Transport rate for a non-resident of $280.00 3. A mileage rate established of$6.00 per loaded mile transporting patients to facilities located outside of Seminole and Orange Counties. June 26, 2000 Regular Agenda Item "F" Page 2 4. Regarding emergency medical patient transport, when a resident of Winter Springs is transported from within the city limits by another entity, the resident will pay only the established fee for a city resident. The balance of the bill will be forwarded to the City of Winter Springs for payment from the Medical Transport Services Fund. C. February 14,2000 - United States Department of Health & Human Services, Health Care Financing Administration (HCF A) RCF A reached an agreement outlining a national fee schedule for Medicare payments for ambulance services. The new fee structure, to be implemented over four years starting in January 2001, will eliminate the widely varying service rates across the United States under the current system, which relies on historical charges to set the amount an ambulance provider can recover from a regional Medicare "carrier" or intermediary. In its place, every request for payment to Medicare for an ambulance transport will be the same amount for a base transportation rate and payment for each mile a Medicare patient is transported. It is also anticipated that most insurance carriers will rely upon this established fee structure for reimbursement for ambulance services as the insurance industry currently uses established Medicare reimbursement rates as their basis of payment. D. April 25, 2000 - Seminole County Board of County Commissioners Seminole County adopted a Resolution to allow the Fire Rescue Division to charge for emergency and non-emergency transport services the maximum allowable charge as determined by Medicare effective May 1,2000. The current maximum allowable by Medicare is $304.51 for transport and $4.81 per loaded mile for mileage charges, Seminole County's rate prior to May 1,2000 was a flat fee of $280.00. Other cities and providers are currently studying or implementing similar fee schedules as Seminole County has done. E. Considerations Since the City of Winter Springs Fire Department began emergency medical patient transport services, the Medical Transport Budget has absorbed an increasing amount of the direct costs of providing Emergency Medical Services from the Fire Department General Fund Budget. The 1996 Department proposal to the City was that the Medical Transport fee would provide relief to the General Fund Budget for the incremental cost of personnel time, supplies associated with the transport, and 50% of the replacement cost of the vehicle. The Medical Transport fund has provided the incremental cost of personnel time for transport, but all medical supplies, equipment, and 100% of the vehicle replacement fee has been budgeted in the past couple of years to come out of the Medical Transport fund and not the General Fund. The two (2) transport vehicles that have been purchased over the last two (2) budget years would have been split 50/50 between the General Fund and the Medical Transport Fund and would have been $135,000.00 each. June 26, 2000 Regular Agenda Item "F" Page 3 However, the Medical Transport fund has purchased both vehicles at a total of $270,000.00. This extra expense to the Medical Transport Fund has caused a projected budget deficit of approximately $20,000 in revenues for the upcoming budget year. If approved to charge the maximum allowable Medicare rate it is anticipated that this deficit will be eliminated and a reserve in the fund will be carried over. Discussion on the fact that current City residents receive a smaller transport bill than do non-residents has prompted us to provide the following information. Paver Catef!ory Percentaf!e of Transports Percent Collected Insurance 51% 71% Medicaid 4% 23% Medicare 25% 82% Veterans .025% 33% Workers Compensation .075% 62% Self Pay 20% 14% As indicated above most of the medical transports are for patients with insurance and Medicare. As previously stated most insurance companies reimburse to the Medicare established rate, so to have a lower rate for residents versus non-residents helps subsidize the insurance industry and does nothing to lower the rates for the citizens of Winter Springs. If the recommended Medicare fee structure is adopted, the economic impact will generate additional revenue for the Medical Transport Fund and help to offset increasing operational costs and well as reduce the need for additional tax revenues to fund these costs. F. June 12,2000 - Regular Meeting City Commission The City Commission approved Regular Agenda Item E whereby the Fire Department was presenting a change to the fees and charges for ambulance transport and loaded mileage that shall not exceed the maximum allowable charge, as determined by Medicare, and henceforth charges for these services shall automatically be adjusted to coincide with the Medicare approved rate(s). It was also stated that the Fire Department would bring back a Resolution (Attachment 1) at the next City Commission meeting to change the currently established fees and charges to the new fees and charges structure as established by Medicare. June 26, 2000 Regular Agenda Item "F" Page 4 FUNDING: No additional funding is required. Fees collected for tlns service will be deposited in the Medical Transport Services Fund and will be expended as approved by the City Commission in the budget process. RECOMMENDATION: The Fire Department recommends that the City Commission adopt Resolution Number 2000-17, that the fees and charges for ambulance transport and loaded mileage shall not exceed the maximum allowable charge, as detemlined by Medicare, and henceforth charges for these services shall automatically be adjusted to coincide with the Medicare approved rate(s). IMPLEMENTATION: Upon adoption of Resolution Number 2000-17 as set forth by the City Commission. ATTACHMENTS: 1. Copy of Resolution Number 2000-17. COMMISSION ACTION: RESOLUTION NUMBER 2000-17 A RESOLUTION OF THE CITY OF WINTER SPRINGS, FLORIDA, CHANGING THE FEE SCHEDULE FOR EMERGENCY MEDICAL PATIENT TRANSPORT WHEREAS, the City Commission of the City of Winter Springs, has the authority to operate an emergency medical patient transport service for the geographical boundaries of the City of Winter Springs; and WHEREAS, the City Commission has the authority to regulate fees for services within the geographical boundaries of the City of Winter Springs; and WHEREAS, Medicare regularly reviews and adjusts the maximum allowable amount for reimbursement of fees for emergency medical patient transport services; and WHEREAS, the City Commission has determined that the maximum allowable charge for emergency medical patient transport services should not exceed the maximum allowable charge, as determined by Medicare, and NOW, THEREFORE, BE IT RESOLVED by the City Commission of the City of Winter Springs, Florida, that the fees and charges for emergency medical patient transport services and loaded mileage shall not exceed the maximum allowable charge, as detennined by Medicare, and henceforth charges for these services shall automatically be adjusted to coincide with the Medicare approved rate(s). BE IT FURTHER RESOLVED that other resolutions or parts of resolutions in conflict herewith by establishing fees inconsistent with those established herein are hereby repealed. All fees established herein shall go into effect July I, 2000. Passed and adopted this 26th day of June, 2000. ATTEST: F WINTER S'p~GS, Fi,ORIDA \ _ r , \ ( ( , iJ ( ~'J U. A-... J1 ',__ ANDREA I;.9R-ENZO-LUACES, CITY CLERK