Commission hears EMS-billing concerns as pharmaceutical costs outpace budgets

Pittsylvania County Fire and Rescue officials reported Thursday that the county and volunteer agencies are spending more than expected on pharmaceuticals and supplies used in EMS responses, and that current billing rates may not cover the new costs.

Chief Fowler, speaking for the EMS billing committee, said the county has "way undershot the budget" for drugs since agencies began carrying and purchasing medicines at the agency level. Fowler said the committee is "revisiting the EMS rates with Medicare and Medicaid in mind" to ensure rates better reflect real costs.

Director Key told the commission he had contacted the county attorney about a rewrite of the relevant county ordinance, but that the attorney had scrapped a draft and started over because it did not use preferred language. "I don't have an update on that yet," Director Key said, and commissioners asked staff to follow up so the commission can proceed with billing changes.

Committee members said agencies historically did not itemize drug charges on patient bills and that state rules limit how some items can be billed. As a result, the committee is considering whether to adjust whole-transport rates rather than try to itemize pharmaceuticals. Chief Fowler said a full financial picture may take six months to a year to emerge, but that available budgeted money for drugs had been exhausted.

No formal ordinance change or rate increase was adopted at the meeting; commissioners asked the committee and county staff for updates and additional data for budgeting and rate-setting discussions.

The commission also discussed that once an ordinance and rate proposal are drafted, further review and likely public notice will be required before any changes take effect.