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Council debates EMS billing changes; motion to table fails amid public concern
Summary
The council debated Ordinance 25-25 on Aug. 4, which would revise Muncie’s EMS billing schedule to align with state law and updated payer practice; officials said most transports are Medicare/Medicaid and that changes primarily affect out-of-network billing.
The Muncie Common Council on Aug. 4 debated Ordinance 25-25, which would amend Chapter 35, Section 22 of the Muncie City ordinance governing emergency medical service (EMS) fees and collections to conform with state law and updated billing practices.
Fire department leadership and the council’s attorney briefed members that the state-level change (House Bill 1385, adopted 2024) and practices in nearby Delaware County prompted a review of the city fee schedule. The chief explained that Medicare and Medicaid account for a majority of transports and that negotiated payers limit what the city can actually collect: "53% of our transports are Medicare, and 30% are Medicaid," the chief said. Staff said out-of-network or out-of-contract carriers represent a small share of calls — about 2% — and that raising rates to the proposed maximum could produce additional revenue; officials estimated a theoretical maximum around $252,000 annually but said a realistic figure might be closer to $150,000.
The proposed ordinance would set rates tied to CMS figures (the chief described the option of capping at 400% of CMS rates) and would adjust mileage and other charge lines. The presentation included sample arithmetic: the chief noted a 400% cap on certain transport types and gave CMS-based examples for BLS and ALS transports. Staff also described an existing hardship mechanism: the chief or a designee may cancel or write off bills in hardship cases, and the department was advised by the billing company to coordinate hardship determinations with hospitals and their financial-assistance procedures.
Public commenters and council members raised concerns about effects on insured residents who have high deductibles or co-pay obligations. One commenter who works with people experiencing homelessness warned that higher billed rates could increase insurance costs or create burdens for people caught in coverage gaps. Council members urged the administration to define a clear, consistent hardship policy and to provide an implementation protocol before increasing rates.
At the meeting, a motion to table the ordinance and refer it to the public safety committee (to allow staff to gather additional information and produce an implementation protocol) was made and seconded. The motion to table and refer failed on a roll-call vote recorded in the transcript: McIntosh (yes); Selby (no); Gollia (yes); Basham (no); Dishman (no); Powell (yes); Green (no); Garrett (no); Mason (yes) — tally 4 yes, 5 no. The transcript records extensive discussion and public comment but does not contain a clear final roll-call adoption of the ordinance in the excerpted record.
Several stakeholders spoke in favor of carefully updating rates to reflect higher operating costs — including union representatives and fire personnel who described equipment and vehicle-price increases since 2019 — and said the city’s existing fee schedule dates to earlier years and may no longer cover costs. Others urged caution, asking for a protocol for hardship determinations and more public information on how changes would affect insurance co-pays, deductibles and out-of-pocket costs.
Council members asked the administration and the city attorney to return with clarified rate tables, hardship procedures, and an assessment of likely impacts on residents before taking final action.
