Mayor Adrian M. Fenty‘s budget, announced last week, indicated a hike in ambulance fees expected to generate an additional $7.24 million in fiscal 2009. There was, however, no accounting at that time of just how much of a bump there would be.
Well, the numbers are out—-they were included in an emergency rulemaking published in last Friday’s D.C. Register. And they represent a significant jump.
A “basic life support” ambulance, which includes care from firefighters/EMTs, now costs $268 a ride. An “advanced life support” ambo, which is staffed by paramedics, costs $471.
Under the proposed rules, BLS ambulance rides will cost $530—-a nearly two-fold increase, while ALS rides will cost $832. The new rules also add a third category, for “Advanced Life Support—-Level 2,” that will cost $953. “Level 2” fees apply when a certain amount of intravenous drugs are administered or when any number of medical procedures are performed, including manual defibrillation, intubation, central-line insertion, or surgically opening an airway.
Also new: A $6.60 per mile surcharge on top of the rest of the fees. (It’s not specified whether that charge includes the trip to pick you up or just the trip to take you to the hospital.)
William Singer, Fenty’s budget czar, says the fee hike was recommended by a task force on EMS reform created in the wake of the David Rosenbaum death. After consulting a survey of 200 cities done by a national EMS organization, he says, they found that the District was “well below the mean” when it comes to ambulance fees.
Singer makes the point that this is a burden rarely borne directly by the average citizen: “This is a medical service and we can recover some of the cost from private insurers and Medicaid,” he says. The District, he says, rarely pushes to collect the fees from uninsured patients. Another hope is that hiking the fees will lead to fewer uses of ambulances for nonemergency uses—-transporting patients between hospitals or nursing homes, for instance.
Care to tell the mayor how you feel? A public hearing is being held this morning at 10 a.m. at Fire & EMS headquarters at 1923 Vermont Ave. NW—-that’s only seven days after publication of the rules in the D.C. Register. That’s quite a bit less than the 15 days customary for rulemakings like these. (Written comments are being accepted until April 10.)
Singer says the short notice is appropriate: “This issue has been talked about quite a bit over the last year.”
Photo by Daquella manera