Fire chiefs lobby state to halt ambulance-fee policy

Fire chiefs oppose policy of insurer paying patient directly, saying it leads to fraud

By Chris Camire
The Lowell Sun

BOSTON — Dozens of fire chiefs from across the state lobbied the Senate Thursday to strike down a policy that forces ambulance companies to collect payments directly from the patients they transport to hospitals.

Chiefs are warning the policy is leading to fraud, lawsuits and lost profits.

Last year, Blue Cross Blue Shield of Massachusetts changed the way it pays private ambulance services not enrolled in its network. Rather than pay the ambulance provider directly, the insurer sends a check to the patient, who becomes responsible for paying the ambulance company themselves.

The move was designed to force ambulance providers into the Blue Cross Blue Shield network, which the insurance company argues will save millions of dollars in medical costs. Ambulance providers say this model hurts their profits because patients often pocket the money.

Last month, the House passed legislation forcing health-insurance companies to pay ambulance companies directly for the cost of a ride. The bill is now before the Senate.

"This legislation protects both municipal and private EMS services that provide emergency medical transports," said Marshfield Fire Chief Kevin Robinson, past president of the Fire Chiefs Association of Massachusetts. "These services have significant costs to maintain the state of readiness to provide emergency services 24 hours a day, 365 days a year."

Robinson said insurance companies have been trying to slash reimbursement rates to a price that would not pay the cost of services. This passes costs onto the cities and towns, and ultimately local taxpayers, he said.

"It doesn't save a penny, and it jeopardizes public safety," said Robinson.

Rep. James Cantwell, D-Marshfield, who filed the bill, said direct payment to patients will lead to cases of fraud, in which people call 911 as a way to receive a check from their ambulance company that they will then spend on something other than their bill. Cantwell said ambulance providers will be forced to sue these patients for payment.

Blue Cross Blue Shield spokesman Jay McQuaide has called Cantwell's concerns "a very negative and pessimistic view" of how the system works. He has compared the new model to auto insurance, in which subscribers routinely receive checks from their auto insurers after an accident.

Blue Cross Blue Shield officials estimate that fewer than a third of the state's 150 private ambulance companies are under contract. If these companies joined the network, McQuaide has said the insurer would save about $80 to $100 million in annual ambulance costs.

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